Provider Demographics
NPI:1992964548
Name:CUTTING, SHAWNA M (MD)
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:M
Last Name:CUTTING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:M
Other - Last Name:CUTTING MALKOFF (MALKOFF)
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:RI
Mailing Address - Zip Code:02806-3208
Mailing Address - Country:US
Mailing Address - Phone:312-315-4898
Mailing Address - Fax:401-444-8781
Practice Address - Street 1:593 EDDY STREET
Practice Address - Street 2:APC 5
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903
Practice Address - Country:US
Practice Address - Phone:401-444-5055
Practice Address - Fax:401-444-8781
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD153072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMD15307OtherSTATE LICENSE