=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831419225
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MICHAEL J SCHENDEN MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2010
-----------------------------------------------------
Last Update Date | 06/08/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 201 WEST BIG BEAVER RD SUITE 1130
-----------------------------------------------------
City | TROY
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48084
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-524-0620
-----------------------------------------------------
Fax | 248-524-0934
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 WEST BIG BEAVER RD SUITE 1130
-----------------------------------------------------
City | TROY
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48084
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-524-0620
-----------------------------------------------------
Fax | 248-524-0934
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. MARGARET N RANDALL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 248-524-0620
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 4301046014
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------