Individual
KIM PETER SCHERSCHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2520A Q ST, BEDFORD, IN 47421-4928
(812) 279-4477
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01032022
IN
207P00000X
Emergency Medicine Physician
01032022A
IN
207Q00000X
Family Medicine Physician
Primary
01032022
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086054
BC BS ID NUJMBER
IN
01
—
000000602256
BLUE SHIELD
IN
05
—
100166860A
—
IN
05
—
100166860D
—
IN
Enumeration date
06/09/2005
Last updated
06/08/2016
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