Healthcare Provider Details

I. General information

NPI: 1538200019
Provider Name (Legal Business Name): JAMES SCHELBERG DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GRISWOLD ST STE 1B
DETROIT MI
48226-3480
US

IV. Provider business mailing address

500 GRISWOLD ST STE 1B
DETROIT MI
48226-3480
US

V. Phone/Fax

Practice location:
  • Phone: 313-962-4555
  • Fax:
Mailing address:
  • Phone: 313-962-4555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number5901000836
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: