Provider Demographics
NPI:1073671434
Name:SCHEUFLER, ERIC MAHLON-PAUL (DMD, MD PA)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MAHLON-PAUL
Last Name:SCHEUFLER
Suffix:
Gender:M
Credentials:DMD, MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BUSINESS CENTRE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-6920
Mailing Address - Country:US
Mailing Address - Phone:850-269-7550
Mailing Address - Fax:850-269-7552
Practice Address - Street 1:42 BUSINESS CENTRE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-6920
Practice Address - Country:US
Practice Address - Phone:850-269-7550
Practice Address - Fax:850-269-7552
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 155931223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL200015922Medicare UPIN