Provider Demographics
NPI:1720603277
Name:STUCKART, SHELDON JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:JOSEPH
Last Name:STUCKART
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 1:5024 9TH ST NW UNIT 403
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-3945
Mailing Address - Country:US
Mailing Address - Phone:440-821-2244
Mailing Address - Fax:
Practice Address - Street 1:827 ROCKVILLE PIKE STE E
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1267
Practice Address - Country:US
Practice Address - Phone:301-251-2777
Practice Address - Fax:301-251-1829
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104-557636111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor