Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 4301049899 | MI |
NPI | 1023041274 |
---|---|
Provider Name | Carl F. Schubert |
First Address | Grayling, MI 49738-7074 |
Second Address | Grayling, MI 49738-7074 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 29/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4428520 | (05) | MI |
E16047 | (02) |