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Individual
KEITH SHUTE
Active
Individual
KEITH SHUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9083
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0109410YPNH02
ANTHEM BC/BS
NH
05
—
3072597
—
NH
01
—
3626045001
CIGNA HEALTHCARE
NH
01
—
5830418
AETNA GROUP
—
01
—
9083
STATE LICENSE #
NH
05
—
99003818
—
NH
01
—
P00100702
RAILROAD MEDICARE
—
01
—
RE289602
PTAN MEDICARE
—
01
—
RE7915
MEDICARE GROUP PTAN
—
Enumeration date
08/12/2005
Last updated
03/07/2023
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