Healthcare Provider Details

I. General information

NPI: 1306824321
Provider Name (Legal Business Name): GERALD NICHOLAS SCHMUKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E SAVIDGE ST STE 6
SPRING LAKE MI
49456-2418
US

IV. Provider business mailing address

701 E SAVIDGE ST STE 6
SPRING LAKE MI
49456-2418
US

V. Phone/Fax

Practice location:
  • Phone: 616-566-5441
  • Fax:
Mailing address:
  • Phone: 616-970-2743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301113571
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number4301113571
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: