Healthcare Provider Details

I. General information

NPI: 1639175334
Provider Name (Legal Business Name): GERALD D SCHEIMBERG DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 GITTINGS ST STE 140
SUFFOLK VA
23434-6101
US

IV. Provider business mailing address

707 GITTINGS ST STE 140
SUFFOLK VA
23434-6101
US

V. Phone/Fax

Practice location:
  • Phone: 757-934-0768
  • Fax: 757-925-1901
Mailing address:
  • Phone: 757-934-0768
  • Fax: 757-925-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0103000322
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: