Provider Demographics
NPI:1912980780
Name:SCHEERER, RUDOLPH PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:PAUL
Last Name:SCHEERER
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 1:808 N OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3710
Mailing Address - Country:US
Mailing Address - Phone:561-832-1378
Mailing Address - Fax:561-832-6771
Practice Address - Street 1:808 N OLIVE AVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3710
Practice Address - Country:US
Practice Address - Phone:561-832-1378
Practice Address - Fax:561-832-6771
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-24
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0012442174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL049644800Medicaid
FLD55725Medicare UPIN
FL049644800Medicaid