MEDICARE: DR. HERBERT H. SCHETTLER 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	174400000X	Specialist	017353	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000031102002	OTHER	CT	UNITED HEALTHCARE ID
2	010017353CT01	OTHER	CT	BLUE SHIELD PROVIDER ID
3	017353	OTHER	CT	CONNECTICARE PROVIDER ID
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4314444	OTHER	CT	AETNA PROVIDER ID
6	P531102	OTHER	CT	OXFORD PROVIDER ID
7	00117353300	OTHER	CT	BLUE CARE FAMILY PLAN ID
8	041414	OTHER	CT	HEALTHNET PROVIDER ID

General Provider Information

NPI Number	:	1871591511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT H. SCHETTLER M.D.

Provider Business Mailing Address
First Line	:	538 LITCHFIELD ST
Second Line	:	SUITE 102
City	:	TORRINGTON
State	:	CT
Zip	:	06790-6669
Country	:	US
Telephone Number	:	860-496-8990
Fax Number	:	860-496-7301

Provider Business Practice Location Address
First Line	:	538 LITCHFIELD ST
Second Line	:	SUITE 102
City	:	TORRINGTON
State	:	CT
Zip	:	06790-6669
Country	:	US
Telephone Number	:	860-496-8990
Fax Number	:	860-496-7301

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. HERBERT H. SCHETTLER M.D.” Practice Location

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