=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427007608
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEVEN C SCHATTNER DO PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 621 COURT ST
-----------------------------------------------------
City | WEST BRANCH
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-345-1005
-----------------------------------------------------
Fax | 989-345-1103
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 621 COURT ST
-----------------------------------------------------
City | WEST BRANCH
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-345-1005
-----------------------------------------------------
Fax | 989-345-1103
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. CARMEN L SCHATTNER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 989-345-1005
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------