Healthcare Provider Details

I. General information

NPI: 1215672779
Provider Name (Legal Business Name): ALEKSANDRA SUSAN SCHUM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEKSANDRA ZARZYCKA MD

II. Dates (important events)

Enumeration Date: 04/29/2022
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 HOUSE AVE STE 405
CHEYENNE WY
82001-3180
US

IV. Provider business mailing address

PO BOX 20970
CHEYENNE WY
82003-7020
US

V. Phone/Fax

Practice location:
  • Phone: 307-635-7961
  • Fax: 307-778-5812
Mailing address:
  • Phone: 307-996-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberPENDING
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: