Provider Demographics
NPI:1558454223
Name:SCHUTTE-RODIN, SHARON (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SCHUTTE-RODIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W. RITTENHOUSE SQUARE; SUITE # 2506
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103
Mailing Address - Country:US
Mailing Address - Phone:215-603-2222
Mailing Address - Fax:844-267-9646
Practice Address - Street 1:210 W. RITTENHOUSE SQUARE; SUITE # 2506
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103
Practice Address - Country:US
Practice Address - Phone:215-603-2222
Practice Address - Fax:844-267-9646
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10025300207RS0012X
PAMD029349E207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001281873Medicaid
PAC34485Medicare UPIN
PA001281873Medicaid