Individual
JEREMIAH RYAN SHUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2305 37TH AVE SW, MINOT, ND 58701-7669
(701) 857-5000
Mailing address
PO BOX 5010, MINOT, ND 58702-5010
(701) 418-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PAC0871
ND
363AM0700X
Medical Physician Assistant
Primary
PAC0871
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2020
Last updated
09/24/2025
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