Provider Demographics
NPI:1073547428
Name:SCHEUERMANN, RICHARD E (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:SCHEUERMANN
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 1:617 STOKES RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-3097
Mailing Address - Country:US
Mailing Address - Phone:609-953-8080
Mailing Address - Fax:609-953-2133
Practice Address - Street 1:617 STOKES RD
Practice Address - Street 2:SUITE 9
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-3097
Practice Address - Country:US
Practice Address - Phone:609-953-8080
Practice Address - Fax:609-953-2133
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05929200207Q00000X
PAMD039412L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1036576OtherKEYSTONE MERCY
NJ0708308000OtherKETSTONE/AMERIHEALTH
PA463157OtherHIGHMARK
NJ764734OtherHIGHMARK
PA0010127770001Medicaid
PA0058581000OtherIBC KEYSTONE EAST
PA1036576OtherKEYSTONE MERCY
PA0058581000OtherIBC KEYSTONE EAST
PA463157OtherHIGHMARK