Healthcare Provider Details

I. General information

NPI: 1598708638
Provider Name (Legal Business Name): ROBERT EDWARD SCHALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 04/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 S BROAD ST
HILLSDALE MI
49242-1859
US

IV. Provider business mailing address

32 S BROAD ST
HILLSDALE MI
49242-1859
US

V. Phone/Fax

Practice location:
  • Phone: 517-437-3361
  • Fax:
Mailing address:
  • Phone: 517-437-3361
  • Fax: 517-437-0011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301087230
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: