# JOHN A SHUTTA, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Glade Valley Family Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114923729
- **Authorized official:** JOHN A SHUTTA MD (PRESIDENT)
- **Authorized official phone:** (301) 898-5200

## Contact information

- **Practice address:** 15 E FREDERICK ST, WALKERSVILLE, MD 21793-8234
- **Practice address phone:** (301) 898-5200
- **Practice address fax:** (301) 898-5230
- **Mailing address:** 15 E FREDERICK ST, PO BOX 310, WALKERSVILLE, MD 21793-8234
- **Mailing address phone:** (301) 898-5200
- **Mailing address fax:** (301) 898-5230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | MD | Yes |

## Other

- **Enumeration date:** 06/28/2005
- **Last updated:** 07/21/2022