Provider Demographics
NPI:1174629133
Name:CHEUVRONT, TIMOTHY SHAWN (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:SHAWN
Last Name:CHEUVRONT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9940 MONROE RD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5347
Mailing Address - Country:US
Mailing Address - Phone:704-841-2200
Mailing Address - Fax:704-841-2534
Practice Address - Street 1:9940 MONROE RD
Practice Address - Street 2:SUITE #101
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5347
Practice Address - Country:US
Practice Address - Phone:704-841-2200
Practice Address - Fax:704-841-2534
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2128111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0872EOtherBLUE CROSS BLUE SHIELD
NC5315633OtherAETNA
NC890872EMedicaid
NC890872EMedicaid
U02481Medicare UPIN