Provider Demographics
NPI:1104889740
Name:SCHUTRUMPF, ANDREW C (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:C
Last Name:SCHUTRUMPF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 HANSHAW RD STE C
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1549
Mailing Address - Country:US
Mailing Address - Phone:804-387-2328
Mailing Address - Fax:607-319-0492
Practice Address - Street 1:905 HANSHAW RD STE C
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1549
Practice Address - Country:US
Practice Address - Phone:804-387-2328
Practice Address - Fax:607-319-0492
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056695207R00000X
NY184266207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA292573OtherMAMSI
VA110217727OtherRAILROAD MEDICARE
VA4902989OtherCIGNA
VA5569579OtherAETNA LIFE
VA43931OtherSENTARA
VAC06689OtherGROUP PTAN
VA122921OtherSOUTHERN HEALTH SERVICES
VA228139OtherANTHEM BCBS OF VA
VA5569579OtherAETNA HMO
VA010017033Medicaid
VA110217727OtherRAILROAD MEDICARE
VA43931OtherSENTARA