Healthcare Provider Details

I. General information

NPI: 1174633879
Provider Name (Legal Business Name): ROBERT ADAM SCHULMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 11/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 MONTGOMERY DR STE 120
SANTA ROSA CA
95404-6617
US

IV. Provider business mailing address

95 MONTGOMERY DR STE 120
SANTA ROSA CA
95404-6617
US

V. Phone/Fax

Practice location:
  • Phone: 415-893-8399
  • Fax: 866-280-2348
Mailing address:
  • Phone: 415-839-8399
  • Fax: 866-280-2348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number0101255067
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number190195
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberG88960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: