Healthcare Provider Details

I. General information

NPI: 1598977316
Provider Name (Legal Business Name): DENISE SCHIEBOUT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 W CHISHOLM ST
ALPENA MI
49707-1401
US

IV. Provider business mailing address

1501 W CHISHOLM ST
ALPENA MI
49707-1401
US

V. Phone/Fax

Practice location:
  • Phone: 989-356-5228
  • Fax: 989-356-5238
Mailing address:
  • Phone: 989-356-5228
  • Fax: 989-356-5238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License Number5101009581
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101009581
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: