1639294796 NPI number — MICHAEL L SCHEER D.O

Table of content: MICHAEL L SCHEER D.O (NPI 1639294796)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639294796 NPI number — MICHAEL L SCHEER D.O

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHEER
Provider First Name:
MICHAEL
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O
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:
1639294796
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
449621 US HIGHWAY 301
Provider Second Line Business Mailing Address:
STE 110
Provider Business Mailing Address City Name:
CALLAHAN
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32011-9348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-507-2692
Provider Business Mailing Address Fax Number:
904-507-2693

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
449621 US HIGHWAY 301
Provider Second Line Business Practice Location Address:
STE 110
Provider Business Practice Location Address City Name:
CALLAHAN
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32011-9348
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-507-2692
Provider Business Practice Location Address Fax Number:
904-507-2693
Provider Enumeration Date:
03/20/2007

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: 207R00000X , with the licence number:  OS5845 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: 34002466 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 80673 . This is a "BC/BS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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