Healthcare Provider Details

I. General information

NPI: 1356348122
Provider Name (Legal Business Name): JACK R SCHERER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 N MICHIGAN AVE STE 81
GREENSBURG IN
47240-1487
US

IV. Provider business mailing address

801 YORK ST
MANITOWOC WI
54220-4630
US

V. Phone/Fax

Practice location:
  • Phone: 812-222-0202
  • Fax: 812-222-0204
Mailing address:
  • Phone: 920-663-9008
  • Fax: 920-684-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number01023422
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: