Provider Demographics
NPI:1083641195
Name:SCHOCK, ANDREW R (PA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:R
Last Name:SCHOCK
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:118 PONDEROSA AVE
Mailing Address - Street 2:
Mailing Address - City:HILL CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57745-6058
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:118 PONDEROSA AVE
Practice Address - Street 2:
Practice Address - City:HILL CITY
Practice Address - State:SD
Practice Address - Zip Code:57745-6058
Practice Address - Country:US
Practice Address - Phone:605-394-2118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2022-11-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical