Individual
DR. JAMIE DAVID SHUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6250 N DURANGO DR, LAS VEGAS, NV 89149-3916
(702) 342-9990
(702) 485-2372
Mailing address
PO BOX 25317, #207, TAMPA, FL 33622-5317
(813) 286-0033
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2011-00052
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25728
NV
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
D0091999
MD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD036095
DC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME 98596
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
R9435
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01299
BLUE CROSS BLUE SHIELD
FL
01
—
162VJ
BCBSNC
NC
05
—
278431900
—
FL
05
—
5916767
—
NC
Enumeration date
05/26/2006
Last updated
12/19/2024
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