Healthcare Provider Details

I. General information

NPI: 1790974210
Provider Name (Legal Business Name): DUANE EDWARD SCHOLTENS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2007
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E SHERMAN BLVD
MUSKEGON MI
49444-1849
US

IV. Provider business mailing address

143 DENNIS AVE
FRUITPORT MI
49415-9755
US

V. Phone/Fax

Practice location:
  • Phone: 231-672-3027
  • Fax:
Mailing address:
  • Phone: 231-865-6820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601005101
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: