Provider Demographics
NPI:1528075777
Name:SCHISSEL, STEPHEN A (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:SCHISSEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:24 MORRILL PLACE
Mailing Address - Street 2:LAHEY AMESBURY
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913
Mailing Address - Country:US
Mailing Address - Phone:978-388-5050
Mailing Address - Fax:978-388-4035
Practice Address - Street 1:24 MORRILL PLACE
Practice Address - Street 2:LAHEY AMESBURY
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913
Practice Address - Country:US
Practice Address - Phone:978-388-5050
Practice Address - Fax:978-388-4035
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-01-26
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Provider Licenses
StateLicense IDTaxonomies
MA71327207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110047623AMedicaid
MAJ0903901Medicare PIN