Provider Demographics
NPI:1942351853
Name:SHUCK, LINDA M (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:M
Last Name:SHUCK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:PLEVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 920
Mailing Address - Street 2:306 WHITE STREET
Mailing Address - City:DOBSON
Mailing Address - State:NC
Mailing Address - Zip Code:27017-0920
Mailing Address - Country:US
Mailing Address - Phone:336-386-4477
Mailing Address - Fax:336-386-8005
Practice Address - Street 1:306 WHITE ST
Practice Address - Street 2:UNIT 1
Practice Address - City:DOBSON
Practice Address - State:NC
Practice Address - Zip Code:27017-8938
Practice Address - Country:US
Practice Address - Phone:336-386-4477
Practice Address - Fax:336-386-8005
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-00550207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC140AVOtherBCBS
NC5901096Medicaid
NC37753OtherPARTNERS
NC37753OtherPARTNERS
NC5901096Medicaid