Shada, Victor A

Shada, Victor A is an individual health care provider with primary practice located at 1264 Dayton Ave , Crossville TN 38555-6175. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shada, Victor A can be contacted via phone (931) 484-4560.

Contact Information

Primary practice address
1264 Dayton Ave Crossville TN 38555-6175
Fax: (931) 484-1480
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1424 Tennessee

Profile Details

NPI number 1851390728
LBN Legal business name Shada, Victor A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Apr 26th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1851390728 NPPES
Tennessee MEDICAID 33068751

Popular Providers