Provider Demographics
NPI:1518993021
Name:HIGHLAND OB/GYN CLINIC, PA
Entity Type:Organization
Organization Name:HIGHLAND OB/GYN CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-485-1191
Mailing Address - Street 1:2301 ROBESON ST
Mailing Address - Street 2:STE 201
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-5551
Mailing Address - Country:US
Mailing Address - Phone:910-485-1191
Mailing Address - Fax:910-485-6006
Practice Address - Street 1:2301 ROBESON ST
Practice Address - Street 2:STE 201
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5551
Practice Address - Country:US
Practice Address - Phone:910-485-1191
Practice Address - Fax:910-485-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901448Medicaid
NC01793OtherGRP BCBS
NC10696OtherBARNES BCBS
NC8910696Medicaid
NC13997OtherANDERSON BCBS
NC8901793Medicaid
NC8901793Medicaid
NC5901448Medicaid
NCH87073Medicare UPIN
NC10696OtherBARNES BCBS
NC2045120Medicare ID - Type UnspecifiedDR ANDERSON
NC230206Medicare ID - Type UnspecifiedGRP MCARE