Provider Demographics
NPI:1114913217
Name:SCHUCHARD, TIMOTHY N (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:N
Last Name:SCHUCHARD
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 1:1200 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2735
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:320-240-2118
Practice Address - Street 1:1200 6TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-5131
Practice Address - Fax:320-240-2118
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN36417207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
122760OtherU CARE
COMPOtherMMSI
46Q81SCOtherBLUE CROSS BLUE SHIELD
COMPOtherCHAMPUS
1016655OtherPREFERRED ONE
773478OtherARAZ GROUP AMERICAS PPO
HP26002OtherHEALTH PARTNERS
2116683OtherFIRST HEALTH PLAN
2507194OtherMEDICA HEALTH PLANS
122760OtherU CARE