Provider Demographics
NPI:1326209149
Name:SCHUTTE, JOSHUA (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:
Last Name:SCHUTTE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4469 MARKET COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-6033
Mailing Address - Country:US
Mailing Address - Phone:571-218-9228
Mailing Address - Fax:
Practice Address - Street 1:4469 MARKET COMMONS DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-6033
Practice Address - Country:US
Practice Address - Phone:571-218-9228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001766152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist