Provider Demographics
NPI:1639175334
Name:SCHEIMBERG, GERALD D (DPM)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:D
Last Name:SCHEIMBERG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 GITTINGS ST
Mailing Address - Street 2:STE 140
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-6101
Mailing Address - Country:US
Mailing Address - Phone:757-934-0768
Mailing Address - Fax:757-925-1901
Practice Address - Street 1:707 GITTINGS ST
Practice Address - Street 2:STE 140
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-6101
Practice Address - Country:US
Practice Address - Phone:757-934-0768
Practice Address - Fax:757-925-1901
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000322213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0811FOtherNC BLUE SHIELD NUMBER
VA257907OtherANTHEM BLUE SHIELD NUMBER
VA311366OtherMAMSI NUMBER
VA25156OtherOPTIMA NUMBER
VA3923930001OtherMEDICARE DME NUMBER
NC8908164OtherNC MEDICAID NUMBER
NC8908164OtherNC MEDICAID NUMBER