Provider Demographics
NPI:1740292176
Name:SCHICKLER, WILLIAM J (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:SCHICKLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 CENTURIAN DR
Mailing Address - Street 2:SUITE 307
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2137
Mailing Address - Country:US
Mailing Address - Phone:302-543-8100
Mailing Address - Fax:302-543-8905
Practice Address - Street 1:1 CENTURIAN DR
Practice Address - Street 2:SUITE 307
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2137
Practice Address - Country:US
Practice Address - Phone:302-543-8100
Practice Address - Fax:302-543-8905
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2013-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC100026582086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
510315372OtherTAX ID
MD536400100Medicaid
DE000097601Medicaid
DEC48770OtherBLUE CROSS
0105929000OtherDELAWARE VALLEY HMO
C48770OtherMIDATLANTIC
PA0105929000OtherKEYSTONE HEALTH PLAN
NJ7039905Medicaid
510315372001OtherCHAMPUS
1404977OtherUMWA
510315372OtherTAX ID
C48770OtherMIDATLANTIC
0105929000OtherDELAWARE VALLEY HMO