Healthcare Provider Details

I. General information

NPI: 1205834447
Provider Name (Legal Business Name): MARY J SCHEIMANN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 DURHAM RD BDG 3, C-1
GUILFORD CT
06437-2076
US

IV. Provider business mailing address

5 DURHAM RD BDG 3, C-1
GUILFORD CT
06437-2076
US

V. Phone/Fax

Practice location:
  • Phone: 203-453-4444
  • Fax: 203-458-9477
Mailing address:
  • Phone: 203-453-4444
  • Fax: 203-458-9477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number029519
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: