Provider Demographics
NPI:1790735603
Name:SCHACHT, LAWRENCE RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:RICHARD
Last Name:SCHACHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1511 MALLARD LANDING CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-5588
Mailing Address - Country:US
Mailing Address - Phone:636-532-1152
Mailing Address - Fax:314-289-7036
Practice Address - Street 1:915 N GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106-1621
Practice Address - Country:US
Practice Address - Phone:314-289-7676
Practice Address - Fax:314-289-7036
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6 P75207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOVAD 000Medicare UPIN