Healthcare Provider Details

I. General information

NPI: 1467429332
Provider Name (Legal Business Name): MICHAEL R SCHUMACHER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 W RADIO LN
ARKANSAS CITY KS
67005-4011
US

IV. Provider business mailing address

510 W RADIO LN
ARKANSAS CITY KS
67005-4011
US

V. Phone/Fax

Practice location:
  • Phone: 620-442-2100
  • Fax: 620-442-8426
Mailing address:
  • Phone: 620-442-2100
  • Fax: 620-442-8426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number15-00017
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: