Provider Demographics
NPI:1417901208
Name:SHUHLER, PHYLLIS M (MD)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:M
Last Name:SHUHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:M
Other - Last Name:SCHWARZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:101 W 7TH ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:PENNSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18073-1512
Mailing Address - Country:US
Mailing Address - Phone:215-679-9321
Mailing Address - Fax:
Practice Address - Street 1:101 W 7TH ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-1512
Practice Address - Country:US
Practice Address - Phone:215-679-9321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025581E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB40846Medicare UPIN