MEDICARE: PETER LEIF SCHILLING MD

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	207X00000X	Orthopaedic Surgery Physician	A101376	CA
2	207X00000X	Orthopaedic Surgery Physician	4301091173	MI
3	207X00000X	Orthopaedic Surgery Physician	20992	NH

General Provider Information

NPI Number	:	1780859850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER LEIF SCHILLING MD

Provider Business Mailing Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:
City	:	LEBANON
State	:	NH
Zip	:	03756-1000
Country	:	US
Telephone Number	:	603-650-5133
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 E MEDICAL CENTER DR
Second Line	:	2912 TAUBMAN CENTER, SPC 5328
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-5000
Country	:	US
Telephone Number	:	734-232-6343
Fax Number	:	734-647-3277

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

Provider Enumeration Date	:	04/29/2008
Last Update Date	:	11/17/2020

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