MEDICARE: DR. JENNIFER SCHERER OUWELEEN M.D.

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	207R00000X	Internal Medicine Physician	204307-1	NY

General Provider Information

NPI Number	:	1700065281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER SCHERER OUWELEEN M.D.

Provider Business Mailing Address
First Line	:	LOGRASSO HALL HEALTH CENTER
Second Line	:	STATE UNIVERSITY OF NEW YORK AT FREDONIA
City	:	FREDONIA
State	:	NY
Zip	:	14063-1127
Country	:	US
Telephone Number	:	716-673-3131
Fax Number	:	716-672-4722

Provider Business Practice Location Address
First Line	:	LOGRASSO HALL HEALTH CENTER
Second Line	:	STATE UNIVERSITY OF NEW YORK AT FREDONIA
City	:	FREDONIA
State	:	NY
Zip	:	14063-1127
Country	:	US
Telephone Number	:	716-673-3131
Fax Number	:	716-672-4722

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

Provider Enumeration Date	:	10/31/2007
Last Update Date	:	10/31/2007

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