Provider Demographics
NPI:1891817748
Name:SCHAECKENBACH, ANDREW E (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:E
Last Name:SCHAECKENBACH
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 1:540 E JEFFERSON ST STE 205
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245
Mailing Address - Country:US
Mailing Address - Phone:319-339-3921
Mailing Address - Fax:319-339-3858
Practice Address - Street 1:540 E JEFFERSON ST STE 205
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245
Practice Address - Country:US
Practice Address - Phone:319-339-3921
Practice Address - Fax:319-339-3858
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA357832083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine