1659358182 NPI number — MARC J SCHECHTER MD

Table of content: MARC J SCHECHTER MD (NPI 1659358182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659358182 NPI number — MARC J SCHECHTER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHECHTER
Provider First Name:
MARC
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1659358182
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5126
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57117-5126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-977-2727
Provider Business Mailing Address Fax Number:
605-339-9244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7307 S GRAND ARBOR CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57108-3151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-941-1866
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/27/2005

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: 208G00000X , with the licence number:  2819 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 448227100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 780002136 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1522672 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2819 . This is a "DAKOTA CARE" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 0008659 . This is a "BCBS" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 41202359600 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 14346 . This is a "SIOUX VALLEY HEALTH PLAN" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".
  • Identifier: 7301224 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 794631 . This is a "AMERICAS PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3617 . This is a "AVERA HEALTH PLAN" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com