Healthcare Provider Details

I. General information

NPI: 1285653782
Provider Name (Legal Business Name): JOHN ANDREW SCHEFFEL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 VERNON ST
WORCESTER MA
01610-1988
US

IV. Provider business mailing address

PO BOX 34666
BELFAST ME
04915-0624
US

V. Phone/Fax

Practice location:
  • Phone: 508-755-2466
  • Fax: 508-755-6883
Mailing address:
  • Phone: 508-755-2466
  • Fax: 508-755-6883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2171
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number2171
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: