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Individual

MARK ALAN SCHICKLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
2409 MAIN ST, BRIDGEPORT, CT 06606-5324
(203) 334-6955
(203) 334-2851
Mailing address
2409 MAIN ST, BRIDGEPORT, CT 06606-5324
(203) 334-6955
(203) 334-2851

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
174
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001931
HEALTHNET
01
030000174CT02
BLUE SHIELD
05
4070447
CT
01
567628
AETNA
Enumeration date
08/31/2006
Last updated
10/01/2008
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