Provider Demographics
NPI:1659321610
Name:SHTUTMAN, NATALYA (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALYA
Middle Name:
Last Name:SHTUTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 DUCKHORN DR 200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-2590
Mailing Address - Country:US
Mailing Address - Phone:916-419-9900
Mailing Address - Fax:916-419-9699
Practice Address - Street 1:3831 NORTH FREEWAY BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834
Practice Address - Country:US
Practice Address - Phone:916-993-8535
Practice Address - Fax:916-285-5274
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80226208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation