Provider Demographics
NPI:1821038548
Name:SCHURMAN, SCOTT JOHN (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:JOHN
Last Name:SCHURMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 IRVING AVE
Mailing Address - Street 2:CROUSE POB STE 801
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1603
Mailing Address - Country:US
Mailing Address - Phone:315-464-6340
Mailing Address - Fax:315-464-6329
Practice Address - Street 1:725 IRVING AVE
Practice Address - Street 2:CROUSE POB STE 801
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1603
Practice Address - Country:US
Practice Address - Phone:315-464-6340
Practice Address - Fax:315-464-6329
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2226962080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02180234Medicaid
NY02180234Medicaid
NYCC9449Medicare PIN