MEDICARE: TONI J SCHEPER OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2331	MN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	410003723	OTHER	MN	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366429797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI J SCHEPER OD

Provider Business Mailing Address
First Line	:	17411 IONIA PATH
Second Line	:
City	:	LAKEVILLE
State	:	MN
Zip	:	55044-5624
Country	:	US
Telephone Number	:	952-270-1907
Fax Number	:	612-808-5023

Provider Business Practice Location Address
First Line	:	1063 BURNSVILLE CTR
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55306
Country	:	US
Telephone Number	:	952-435-8821
Fax Number	:	612-808-5023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	07/31/2018

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