Provider Demographics
NPI:1235112863
Name:SCHLUTER, SCOTT GWON (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:GWON
Last Name:SCHLUTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:955 MAIN ST
Practice Address - Street 2:PEDIATRICIANS INC
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-1961
Practice Address - Country:US
Practice Address - Phone:781-729-4262
Practice Address - Fax:781-729-0692
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA204524208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H76304Medicare UPIN