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General NPI Number Information
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NPI Number | 1871566489
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Entity Type | Individual
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Provider Name | GARY J SCHAUB PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6100 US 31 NORTH
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City | WILLIAMSBURG
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State | MI
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Zip | 49690
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Country | US
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Telephone | 231-938-5983
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 515
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City | ACME
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State | MI
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Zip | 49610-0515
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Country | US
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Telephone | 231-938-5983
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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 | 5601001376
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License Number State | MI
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