Provider Demographics
NPI:1588639116
Name:SCHECHTER, MARK DOUGLAS (DPM)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:DOUGLAS
Last Name:SCHECHTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 STATE RD E
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01473-1212
Mailing Address - Country:US
Mailing Address - Phone:978-874-1300
Mailing Address - Fax:978-874-6244
Practice Address - Street 1:32 STATE RD E
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01473-1212
Practice Address - Country:US
Practice Address - Phone:978-874-1300
Practice Address - Fax:978-874-6244
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2203213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA27-01654OtherEVERCARE
MA468350OtherTUFTS HEALTH PLAN
MAAA45518OtherHARVARD PILGRIM HEALTH
MAY71123OtherBLUE SHIELD OF MA
MA90304OtherFALLON HEALTH CARE
MA0324582Medicaid
MA468350OtherTUFTS HEALTH PLAN
MAAA45518OtherHARVARD PILGRIM HEALTH
MA27-01654OtherEVERCARE
MAU74418Medicare UPIN