MEDICARE: MR. MARK ANTHONY SCHIFFNER PA-C

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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1790757532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARK ANTHONY SCHIFFNER PA-C

Provider Business Mailing Address
First Line	:	90 RIVERSIDE DR
Second Line	:
City	:	NORTH BENNINGTON
State	:	VT
Zip	:	05257-9666
Country	:	US
Telephone Number	:	802-442-9597
Fax Number	:

Provider Business Practice Location Address
First Line	:	90 RIVERSIDE DR
Second Line	:
City	:	NORTH BENNINGTON
State	:	VT
Zip	:	05257-9666
Country	:	US
Telephone Number	:	802-442-9597
Fax Number	:

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

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	01/11/2010

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