Provider Demographics
NPI:1669634119
Name:SCHEUER, JACK FRIEDMAN III (MD)
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:FRIEDMAN
Last Name:SCHEUER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2215 RANDOLPH ROAD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207
Mailing Address - Country:US
Mailing Address - Phone:704-372-6846
Mailing Address - Fax:704-342-0752
Practice Address - Street 1:2215 RANDOLPH ROAD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207
Practice Address - Country:US
Practice Address - Phone:704-372-6846
Practice Address - Fax:704-342-0752
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2017-01398208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery