1033201959 NPI number — DR. CALVIN LEE SCHIERER DO

Table of content: DR. CALVIN LEE SCHIERER DO (NPI 1033201959)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033201959 NPI number — DR. CALVIN LEE SCHIERER DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHIERER
Provider First Name:
CALVIN
Provider Middle Name:
LEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033201959
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9734 ROUTE 19
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUGHTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14744-8771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-567-2285
Provider Business Mailing Address Fax Number:
585-567-2202

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5596 ROUTE 19A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CASTILE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14427-9757
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-793-9230
Provider Business Practice Location Address Fax Number:
585-786-0508
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  177372 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 005107171 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MDH353 . This is a "PREFERRED CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P010177372 . This is a "BLUE CHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0102767 . This is a "INDEPENDANT HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00010158802 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: P020177372 . This is a "EXCELLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2134 . This is a "ROCHESTER BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02168981 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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