Provider Demographics
NPI:1538238233
Name:SCHOTTENFELD, MARK ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:SCHOTTENFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3 PROGRESS ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1180
Mailing Address - Country:US
Mailing Address - Phone:908-222-8858
Mailing Address - Fax:908-222-8857
Practice Address - Street 1:3 PROGRESS ST
Practice Address - Street 2:SUITE 106
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1180
Practice Address - Country:US
Practice Address - Phone:908-222-8858
Practice Address - Fax:908-222-8857
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2010-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02668300207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2K8027OtherHEALTHNET
622535OtherKEYSTONE
0090594OtherGHI
0729253001OtherCIGNA
200037871OtherRR MEDICARE
D01072OtherOXFORD
2344157OtherAETNA
2335435000OtherAMERIHEALTH
405774OtherKEYSTONE PIN
200037871OtherRR MEDICARE
2335435000OtherAMERIHEALTH