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NPI Code Detail

MEDICARE: CHRISTOPHER B SCHOOLEY DO, PC

MEDICARE: CHRISTOPHER B SCHOOLEY DO, PC
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
1207RC0000XCardiovascular Disease Physician5101010057MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CS010057OTHERMISTATE LICENSE

General Provider Information

NPI Number : 1609938414
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHRISTOPHER B SCHOOLEY DO, PC
Provider Business Mailing Address
First Line : PO BOX 673400
Second Line :
City : DETROIT
State : MI
Zip : 48267-0001
Country : US
Telephone Number : 734-462-0340
Fax Number : 734-462-0344
Provider Business Practice Location Address
First Line : 19460 GRAND RIVER AVE
Second Line :
City : DETROIT
State : MI
Zip : 48223-1200
Country : US
Telephone Number : 313-387-1047
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. CHRISTOPHER B SCHOOLEY
Credential : DO
Telephone Number : 313-387-1047
Provider Enumeration Date : 12/15/2006
Last Update Date : 08/22/2020

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