Provider Demographics
NPI:1114925005
Name:SCHURICHT, ALAN L (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:SCHURICHT
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 1:301 S 8TH ST
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4000
Mailing Address - Country:US
Mailing Address - Phone:215-829-8455
Mailing Address - Fax:215-829-8454
Practice Address - Street 1:301 S 8TH ST
Practice Address - Street 2:SUITE 4A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-4000
Practice Address - Country:US
Practice Address - Phone:215-829-8455
Practice Address - Fax:215-829-8454
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09025700208600000X
PAMD037959E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001240781-005Medicaid
PAE41462Medicare UPIN
PA001240781-005Medicaid