Healthcare Provider Details

I. General information

NPI: 1942312566
Provider Name (Legal Business Name): GERALD SCHUCHMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13516 CRISPIN WAY
ROCKVILLE MD
20853-2943
US

IV. Provider business mailing address

13516 CRISPIN WAY
ROCKVILLE MD
20853-2943
US

V. Phone/Fax

Practice location:
  • Phone: 301-871-2771
  • Fax: 301-871-2772
Mailing address:
  • Phone: 301-871-2771
  • Fax: 301-871-2772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberAT000868L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: