Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN 15593 | FL |
NPI | 1073671434 |
---|---|
Provider Name | Dr. Eric Mahlon-Paul Scheufler |
First Address | Miramar Beach, FL 32550-6920 |
Second Address | Miramar Beach, FL 32550-6920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 22/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200015922 | (02) | FL |