Healthcare Provider Details

I. General information

NPI: 1679142848
Provider Name (Legal Business Name): CHELSEA SCHOENMAKER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11012 E 13 MILE RD
WARREN MI
48093-2572
US

IV. Provider business mailing address

11012 E 13 MILE RD STE 210
WARREN MI
48093-2547
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-6880
  • Fax: 586-582-5729
Mailing address:
  • Phone: 586-573-6880
  • Fax: 586-582-5729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601010643
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: