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General NPI Number Information
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NPI Number | 1407526825
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Entity Type | Individual
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Provider Name | ALEXIS RAE SCHUITEMA PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 06/21/2024
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Provider Practice Location Address
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Address Line | 2201 CHAPEL AVE W
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2048
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Country | US
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Telephone | 856-488-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 3202 BLUFF VIEW CIR
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City | BORDENTOWN
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State | NJ
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Zip | 08505-1179
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Country | US
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Telephone | 908-399-0032
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00650900
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License Number State | NJ
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