Provider Demographics
NPI:1447248992
Name:SCHIETROMA, JOHN J (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:SCHIETROMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4700 UNION DEPOSIT RD
Mailing Address - Street 2:STE 230
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3774
Mailing Address - Country:US
Mailing Address - Phone:717-541-9700
Mailing Address - Fax:717-541-9705
Practice Address - Street 1:4700 UNION DEPOSIT RD
Practice Address - Street 2:STE 230
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-3774
Practice Address - Country:US
Practice Address - Phone:717-541-9700
Practice Address - Fax:717-541-9705
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2012-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD027344E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B41213Medicare UPIN
PA401661R6TMedicare ID - Type Unspecified