Provider Demographics
NPI:1275696148
Name:SCHACHER, STEPHEN ALAN
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALAN
Last Name:SCHACHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 ALLGOOD RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-5371
Mailing Address - Country:US
Mailing Address - Phone:706-310-0130
Mailing Address - Fax:
Practice Address - Street 1:1500 OGLETHORPE AVE STE 300A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2181
Practice Address - Country:US
Practice Address - Phone:706-389-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0464842083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAA05558Medicare UPIN