Healthcare Provider Details

I. General information

NPI: 1518924778
Provider Name (Legal Business Name): JODI L. SCHUCKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 OSTRUM ST SUITE 303
FOUNTAIN HILL PA
18015-1155
US

IV. Provider business mailing address

701 OSTRUM ST SUITE 303
FOUNTAIN HILL PA
18015-1155
US

V. Phone/Fax

Practice location:
  • Phone: 610-954-3900
  • Fax: 610-954-3908
Mailing address:
  • Phone: 610-954-3900
  • Fax: 610-954-3908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD050489L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD050489L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: