Healthcare Provider Details

I. General information

NPI: 1154379618
Provider Name (Legal Business Name): JOHN STEPHEN SCHECHTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 W 1ST ST
BLOOMINGTON IN
47403-2319
US

IV. Provider business mailing address

719 W 1ST ST
BLOOMINGTON IN
47403-2319
US

V. Phone/Fax

Practice location:
  • Phone: 812-339-6151
  • Fax: 812-339-8884
Mailing address:
  • Phone: 812-339-6151
  • Fax: 812-339-8884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01022335
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: