Provider Demographics
NPI:1073716403
Name:PINDER-SCHENCK, MARY COLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:COLEEN
Last Name:PINDER-SCHENCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:COLLEEN
Other - Last Name:PINDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12902 MAGNOLIA DRIVE
Mailing Address - Street 2:FOB-THORPROG
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612
Mailing Address - Country:US
Mailing Address - Phone:813-745-7640
Mailing Address - Fax:813-745-3027
Practice Address - Street 1:12902 MAGNOLIA DRIVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612
Practice Address - Country:US
Practice Address - Phone:813-745-2826
Practice Address - Fax:813-745-3027
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10021806207RX0202X
FLME104062207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUS9706079OtherAETNA PCP PIN
WAP00460205OtherRAILROAD MC #
WA1749PIOtherBLUE SHIELD #
WA1749PIOtherBLUE SHIELD #
NCU25194Medicare UPIN
WA8869271Medicare PIN
WA8493298Medicaid
WA8869271Medicare PIN