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NPI Code Detail

MEDICARE: DANIEL JERIK SCHELTEMA

MEDICARE: DANIEL JERIK SCHELTEMA
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
1183500000XPharmacist5302039698MI

General Provider Information

NPI Number : 1548570849
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL JERIK SCHELTEMA
Provider Business Mailing Address
First Line : 49201 CRANBROOK DR
Second Line :
City : MACOMB
State : MI
Zip : 48044-1554
Country : US
Telephone Number : 586-506-6220
Fax Number :
Provider Business Practice Location Address
First Line : 40925 GARFIELD RD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-2537
Country : US
Telephone Number : 586-263-4070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2010
Last Update Date : 01/28/2020

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Directions to “ DANIEL JERIK SCHELTEMA ” Practice Location

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