Provider Demographics
NPI:1669472734
Name:SCHER, SUSAN MIRIAM (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:MIRIAM
Last Name:SCHER
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 IRVINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ALGONA
Mailing Address - State:IA
Mailing Address - Zip Code:50511-8500
Mailing Address - Country:US
Mailing Address - Phone:515-272-4499
Mailing Address - Fax:515-295-7908
Practice Address - Street 1:202 3RD ST N
Practice Address - Street 2:BOX 296
Practice Address - City:SWEA CITY
Practice Address - State:IA
Practice Address - Zip Code:50590-1095
Practice Address - Country:US
Practice Address - Phone:515-272-4499
Practice Address - Fax:515-295-7908
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA883363AM0700X, 363AS0400X
MN9268363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Not Answered363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA20068OtherBLUE CROSS
IAI11916Medicare ID - Type Unspecified
IA20068OtherBLUE CROSS