Provider Demographics
NPI:1083665087
Name:NUSCHKE, JOHN D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:NUSCHKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:798 HAUSMAN RD
Practice Address - Street 2:SUITE 220
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9108
Practice Address - Country:US
Practice Address - Phone:610-530-2290
Practice Address - Fax:484-403-4007
Is Sole Proprietor?:No
Enumeration Date:2006-05-14
Last Update Date:2016-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD032252E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010954480002Medicaid
PA110118524OtherPALMETTO RR
PA01037001OtherCAPITAL BLUE CROSS
PA095337OtherHIGHMARK PA BLUE SHIELD
PA0010954480002Medicaid
PAB36209Medicare UPIN
PA095337H9MMedicare PIN