MEDICARE: RUPA SCHODOWSKI MT

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	225700000X	Massage Therapist	7501000225	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396417440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUPA SCHODOWSKI MT

Provider Business Mailing Address
First Line	:	51424 VAN DYKE AVE STE 27
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-4409
Country	:	US
Telephone Number	:	586-258-6841
Fax Number	:

Provider Business Practice Location Address
First Line	:	51424 VAN DYKE AVE STE 27
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-4409
Country	:	US
Telephone Number	:	586-258-6841
Fax Number	:

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

Provider Enumeration Date	:	09/28/2021
Last Update Date	:	09/29/2022

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Directions to “ RUPA SCHODOWSKI MT” Practice Location

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