Healthcare Provider Details
I. General information
NPI: 1831419225
Provider Name (Legal Business Name): MICHAEL J SCHENDEN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2010
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
201 WEST BIG BEAVER RD SUITE 1130
TROY MI
48084
US
IV. Provider business mailing address
201 WEST BIG BEAVER RD SUITE 1130
TROY MI
48084
US
V. Phone/Fax
- Phone: 248-524-0620
- Fax: 248-524-0934
- Phone: 248-524-0620
- Fax: 248-524-0934
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 4301046014 |
| License Number State | MI |
VIII. Authorized Official
Name: MRS.
MARGARET
N
RANDALL
Title or Position: OFFICE MANAGER
Credential:
Phone: 248-524-0620