Matthew Stephen Shute in Fayetteville - Physician Assistant
Matthew Stephen Shute - NPI 1639198526
Matthew Stephen Shute is a Physician Assistant in Fayetteville, New York. Matthew Stephen Shute practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Matthew Stephen Shute is 1639198526. The last update date is 2023-05-08.
Matthew Stephen Shute's current location address is 4000 Medical Center Drive Suite 104, Fayetteville, New York. You can contact this provider via phone number 3156630059 and fax number 3156630123. The mailing address for Matthew Stephen Shute is 4000 Medical Center Drive Suite 104, Fayetteville, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Matthew Stephen Shute |
|---|---|
| Address | 4000 Medical Center Drive Suite 104, Fayetteville, New York |
| Phone Number | 3156630059 |
| Fax Number | 3156630123 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1639198526 |
|---|---|
| Provider Enumeration Date | 2006-07-19 |
| Last Updated Date | 2023-05-08 |
Provider Mailing Address Detail
| Address | 4000 Medical Center Drive Suite 104 |
|---|---|
| City | Fayetteville |
| State | New York (NY) |
| Post Code | 130666635 |
| Phone Number | 3156630059 |
| Fax Number | 3156630123 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 11106 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2300011106 | NY | -- | |
| 2870006 | NY | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Matthew Stephen Shute?
The Matthew Stephen Shute has been issued the NPI (National Provider Identifier) 1639198526 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Matthew Stephen Shute?
The Matthew Stephen Shute is situated at 4000 Medical Center Drive Suite 104, in the city of Fayetteville, state of NY, with the zip code 130666635.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1639198526 to Matthew Stephen Shute?
The Centers for Medicare & Medicaid Services originally issued the 1639198526 to Matthew Stephen Shute on 2006-07-19.
As of what date were the details pertaining to Matthew Stephen Shute last refreshed?
The information related to the Matthew Stephen Shute, including its address, specialty, and other relevant details, was last updated on 2023-05-08.
When was the information regarding Matthew Stephen Shute, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Matthew Stephen Shute, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2023-05-08.