Provider Demographics
NPI:1194897975
Name:SCHUETZ, ELISA CASSANDRA (MD)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:CASSANDRA
Last Name:SCHUETZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-270-7500
Mailing Address - Fax:717-228-1642
Practice Address - Street 1:252 S 4TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-6111
Practice Address - Country:US
Practice Address - Phone:717-270-7500
Practice Address - Fax:717-228-1642
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTP850207L00000X
PAMD467387207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000505303OtherBLUE CROSS
KY7100022820Medicaid
KY7100022820Medicaid
KY3385720Medicare PIN