Provider Demographics
NPI:1063454759
Name:SCHAUER, PETER K (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:K
Last Name:SCHAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 RETREAT AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2527
Mailing Address - Country:US
Mailing Address - Phone:860-249-6291
Mailing Address - Fax:860-728-0151
Practice Address - Street 1:85 RETREAT AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2527
Practice Address - Country:US
Practice Address - Phone:860-249-6291
Practice Address - Fax:860-728-0151
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT018095207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001180959Medicaid
CT830000001Medicare ID - Type Unspecified
CT001180959Medicaid