Provider Demographics
NPI:1346213386
Name:SCHLACHTER, SCOTT M (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:SCHLACHTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:15 MARISA CT
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3534
Mailing Address - Country:US
Mailing Address - Phone:732-660-0126
Mailing Address - Fax:
Practice Address - Street 1:1640 ROUTE 88 W
Practice Address - Street 2:STE. 202
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3036
Practice Address - Country:US
Practice Address - Phone:732-458-8300
Practice Address - Fax:732-458-8529
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05901600207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG04496Medicare UPIN