| John A Shutta, MD | |
|
15 E Frederick St, Walkersville, MD 21793-8234 | |
| (301) 898-5200 | |
| (301) 898-5230 |
| Full Name | John A Shutta |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 15 E Frederick St, Walkersville, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679578983 | NPI | - | NPPES |
| 378781800 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0030020 (Maryland) | Primary |
| Entity Name | Frederick Health Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619258225 PECOS PAC ID: 9931341096 Enrollment ID: O20130820000555 |
| Mailing Address | Practice Location Address |
|---|---|
| John A Shutta, MD Po Box 37086, Baltimore, MD 21297-3086 Ph: (240) 439-8812 | John A Shutta, MD 15 E Frederick St, Walkersville, MD 21793-8234 Ph: (301) 898-5200 |
Virginia C Wiley, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 19 W Frederick St, Walkersville, MD 21793 Phone: 301-845-6336 Fax: 240-578-4478 | |
Dr. Andrew Zarick Jr., MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 9502 Highlander Cir, Walkersville, MD 21793 Phone: 484-554-0580 | |
Richard L Gough, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 19 W Frederick St, Walkersville, MD 21793 Phone: 301-845-6336 Fax: 240-578-4478 |