Provider Demographics
NPI:1033168380
Name:SCHUTZBANK, STEVEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:SCHUTZBANK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BARBARA LN
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-1213
Mailing Address - Country:US
Mailing Address - Phone:215-473-1070
Mailing Address - Fax:
Practice Address - Street 1:7341 BROOKHAVEN RD
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19151-2206
Practice Address - Country:US
Practice Address - Phone:215-473-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA00SC2101L213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00540077Medicaid
PA094624OtherBLUE SHIELD
0556480001Medicare NSC
PA094624OtherBLUE SHIELD
PA094624Medicare ID - Type Unspecified