Provider Demographics
NPI:1598731333
Name:SCHRAUT, GARY E (MD)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:E
Last Name:SCHRAUT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 PROFESSIONAL CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905
Mailing Address - Country:US
Mailing Address - Phone:765-446-9446
Mailing Address - Fax:765-447-9672
Practice Address - Street 1:100 PROFESSIONAL CT
Practice Address - Street 2:SUITE 101
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905
Practice Address - Country:US
Practice Address - Phone:765-446-9446
Practice Address - Fax:765-447-9672
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01042571A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E85809Medicare UPIN
IN189480Medicare ID - Type Unspecified