MEDICARE: ROBERT J SCHMIESS BUNDY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant		ND

General Provider Information

NPI Number	:	1164391074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT J SCHMIESS BUNDY

Provider Business Mailing Address
First Line	:	1635 28TH AVE S APT 11
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-6708
Country	:	US
Telephone Number	:	701-610-6589
Fax Number	:

Provider Business Practice Location Address
First Line	:	1635 28TH AVE S APT 11
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-6708
Country	:	US
Telephone Number	:	701-610-6589
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	10/30/2025

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