TEONDRA SHANTAY MCGRUDER NPI 1407320492

NPI Information

NPI: 1407320492
Provider Name: TEONDRA SHANTAY MCGRUDER
Classification: Specialist - 1744P3200X
Entity Type: Individual

Specialization: Prosthetics Case Management

Address:
1032 LAKEVIEW ST
LOUISVILLE, GA
ZIP 30434
Phone: (478) 206-2864
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Teondra Shantay Mcgruder is a prosthetics case management specialist in Louisville, GA. Teondra Shantay Mcgruder NPI is 1407320492. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1032 LAKEVIEW ST
LOUISVILLE, GA
ZIP 30434-963
Phone: (478) 206-2864

The enumeration date for this NPI number is 1/14/2019 and was last updated on 1/14/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1744P3200X	Specialist	Prosthetics Case Management	CO131457	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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