Provider Demographics
NPI:1912192360
Name:CUTSHAW, SHANE MCNEIL (DC)
Entity Type:Individual
Prefix:DR
First Name:SHANE
Middle Name:MCNEIL
Last Name:CUTSHAW
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 1:13882 US 19
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:NC
Mailing Address - Zip Code:28901-5200
Mailing Address - Country:US
Mailing Address - Phone:828-321-2225
Mailing Address - Fax:828-321-2225
Practice Address - Street 1:13882 US 19
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:NC
Practice Address - Zip Code:28901-5200
Practice Address - Country:US
Practice Address - Phone:828-321-2225
Practice Address - Fax:828-321-2225
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085H2OtherBCBSNC
NC89085H2Medicaid
NC89085H2Medicaid