Provider Demographics
NPI:1326016502
Name:SCHUCK, J CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:J
Middle Name:CHRISTOPHER
Last Name:SCHUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:345 N MAIN ST
Mailing Address - Street 2:SUITE 248
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2515
Mailing Address - Country:US
Mailing Address - Phone:860-231-8453
Mailing Address - Fax:860-523-4061
Practice Address - Street 1:820 PROSPECT HILL RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1559
Practice Address - Country:US
Practice Address - Phone:860-285-8251
Practice Address - Fax:860-687-1774
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0414822080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT719863OtherCONNECTICARE
CT010041482CT02OtherANTHEM BCBS