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NPI Code Detail

MEDICARE: MS. AMBER ERIN SCHAUB PA-C

MEDICARE: MS. AMBER ERIN SCHAUB PA-C
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
1363AS0400XSurgical Physician AssistantPA3859MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA2002OTHERMEPA LICENSE

General Provider Information

NPI Number : 1235464785
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMBER ERIN SCHAUB PA-C
Provider Business Mailing Address
First Line : 15 PARKMAN ST
Second Line : WAC 4
City : BOSTON
State : MA
Zip : 02114-3117
Country : US
Telephone Number : 617-726-6100
Fax Number :
Provider Business Practice Location Address
First Line : 887 CONGRESS ST STE 400
Second Line :
City : PORTLAND
State : ME
Zip : 04102-3163
Country : US
Telephone Number : 207-774-6368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2009
Last Update Date : 12/11/2019

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