Healthcare Provider Details

I. General information

NPI: 1831266485
Provider Name (Legal Business Name): MICHAEL J SCHENDEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W BIG BEAVER RD SUITE 1130
TROY MI
48084-4152
US

IV. Provider business mailing address

201 W BIG BEAVER RD SUITE 1130
TROY MI
48084-4152
US

V. Phone/Fax

Practice location:
  • Phone: 248-524-0620
  • Fax: 248-524-0934
Mailing address:
  • Phone: 248-524-0620
  • Fax: 248-524-0934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number4301046014
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: