Individual
DR. GREGORY MICHAEL SCHACKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MERCADO ST, SUITE 205, DURANGO, CO 81301-7306
(970) 385-7272
(970) 385-7299
Mailing address
1 MERCADO ST, SUITE 205, DURANGO, CO 81301-7306
(970) 385-7272
(970) 385-7299
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
44598
CO
207Y00000X
Otolaryngology Physician
Primary
90296
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84687215
—
CO
Enumeration date
05/10/2006
Last updated
03/26/2010
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