Provider Demographics
NPI:1205086980
Name:SCHEFFEL FOOT CENTER, PC
Entity type:Organization
Organization Name:SCHEFFEL FOOT CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:FLYNN
Authorized Official - Last Name:SCHEFFEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-755-2466
Mailing Address - Street 1:PO BOX 34666
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0624
Mailing Address - Country:US
Mailing Address - Phone:508-755-2466
Mailing Address - Fax:508-755-6883
Practice Address - Street 1:95 VERNON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-1988
Practice Address - Country:US
Practice Address - Phone:508-755-2466
Practice Address - Fax:508-755-6883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2171213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4789510001Medicare NSC