Healthcare Provider Details

I. General information

NPI: 1174755300
Provider Name (Legal Business Name): MICHAEL D SCHULMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2009
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

753 OLD NORCROSS RD
LAWRENCEVILLE GA
30046
US

IV. Provider business mailing address

753 OLD NORCROSS RD
LAWRENCEVILLE GA
30046-4312
US

V. Phone/Fax

Practice location:
  • Phone: 770-545-8888
  • Fax: 770-545-8889
Mailing address:
  • Phone: 770-545-8888
  • Fax: 770-545-8889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR008507
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: