MEDICARE: DR. STEVEN SCHUTZBANK DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213EP1101X	Primary Podiatric Medicine Podiatrist	00SC2101L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	094624	OTHER	PA	BLUE SHIELD

General Provider Information

NPI Number	:	1033168380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN SCHUTZBANK DPM

Provider Business Mailing Address
First Line	:	18 BARBARA LN
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-1213
Country	:	US
Telephone Number	:	215-473-1070
Fax Number	:

Provider Business Practice Location Address
First Line	:	7341 BROOKHAVEN RD
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19151-2206
Country	:	US
Telephone Number	:	215-473-1070
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2006
Last Update Date	:	04/15/2013

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