Healthcare Provider Details

I. General information

NPI: 1457357519
Provider Name (Legal Business Name): WALTER J SCHUYLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 MAINE ST STE 1 BRUNSWICK EYE CARE ASSOCIATES
BRUNSWICK ME
04011-3359
US

IV. Provider business mailing address

331 MAINE ST STE 1 BRUNSWICK EYE CARE ASSOCIATES
BRUNSWICK ME
04011-3359
US

V. Phone/Fax

Practice location:
  • Phone: 207-725-2161
  • Fax: 207-725-9189
Mailing address:
  • Phone: 207-725-2161
  • Fax: 207-725-9189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number011131
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: