Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME103118 | FL |
Y | 208600000X | Surgeon | ME103118 | FL |
N | 2086S0102X | Surgical Critical Care | ME103118 | FL |
N | 2086S0127X | Trauma Surgeon | ME103118 | FL |
NPI | 1013170117 |
---|---|
Provider Name | Christian R Schuetz |
First Address | Fort Pierce, FL 34950-4838 |
Second Address | Fort Pierce, FL 34950-3603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 03/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000658900 | (05) | FL |
17023 | BLUE CROSS BLUE SHIELD (01) | FL |