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General NPI Number Information
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NPI Number | 1154351187
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Entity Type | Organization
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Legal Business Name | PINELAND PLAZA FAMILY PRACTICE, LLC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | 617 STOKES RD SUITE 9
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City | MEDFORD
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State | NJ
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Zip | 08055-3097
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Country | US
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Telephone | 609-953-8080
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Fax | 609-953-2133
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Provider Business Mailing Address
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Address Line | 617 STOKES RD SUITE 9
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City | MEDFORD
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State | NJ
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Zip | 08055-3097
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Country | US
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Telephone | 609-953-8080
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Fax | 609-953-2133
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Authorized Official
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Title or Position | PHYSICAN
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Name | DR. RICHARD E SCHEUERMANN
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Credential | M.D.
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Telephone | 609-953-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA05929200
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License Number State | NJ
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