Healthcare Provider Details

I. General information

NPI: 1497906499
Provider Name (Legal Business Name): THOMAS D SCHOMAKER DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36075 UTICA RD SUITE 100
CLINTON TOWNSHIP MI
48035-1061
US

IV. Provider business mailing address

36075 UTICA RD SUITE 100
CLINTON TOWNSHIP MI
48035-1061
US

V. Phone/Fax

Practice location:
  • Phone: 586-741-0430
  • Fax: 586-741-0482
Mailing address:
  • Phone: 586-741-0430
  • Fax: 586-741-0482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101012706
License Number StateMI

VIII. Authorized Official

Name: KRISTIN SCHOMAKER
Title or Position: OFFICE MANAGER
Credential:
Phone: 586-741-0430