MEDICARE: DR. BENNETT J SHATKIN MD

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	207RC0000X	Cardiovascular Disease Physician	203BC0100Y	NJ

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

General Provider Information

NPI Number	:	1336146695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENNETT J SHATKIN MD

Provider Business Mailing Address
First Line	:	6083 WILDCAT RUN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33412-3006
Country	:	US
Telephone Number	:	609-774-5372
Fax Number	:

Provider Business Practice Location Address
First Line	:	9901 SEAPOINTE BLVD
Second Line	:	#604
City	:	WILDWOOD CREST
State	:	NJ
Zip	:	08260-6203
Country	:	US
Telephone Number	:	609-774-5372
Fax Number	:

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	03/22/2016

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