Provider Demographics
NPI:1013913904
Name:SCHRECK, MICHEAL E (MD)
Entity Type:Individual
Prefix:
First Name:MICHEAL
Middle Name:E
Last Name:SCHRECK
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 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:301 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748-1113
Practice Address - Country:US
Practice Address - Phone:563-285-7232
Practice Address - Fax:563-285-6742
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21198207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
19904OtherIOWA HEALTH SOLUTIONS
IA3152074Medicaid
4796890010OtherDMERC
034790OtherHEALTH ALLIANCE
29595OtherWELLMARK HEALTH PLANS
IA0154OtherJOHN DEERE
034790OtherHEALTH ALLIANCE
I3081Medicare PIN