Provider Demographics
NPI:1013998525
Name:SCHACHTER, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SCHACHTER
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:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-842-5239
Mailing Address - Fax:314-842-3835
Practice Address - Street 1:13303 TESSON FERRY RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-4062
Practice Address - Country:US
Practice Address - Phone:314-842-5239
Practice Address - Fax:314-842-3835
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6P74208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4200656OtherAETNA
MO1200174OtherUHC
MO146255OtherHEALTHLINK
MO24516Other24516
MO40015OtherGHP
MO4313838963JSCOtherMERCY
MO92215275OtherBLUE SHIELD