Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 35067416S | OH |
NPI | 1205838943 |
---|---|
Provider Name | Dr. Douglas James Schumer |
First Address | Mansfield, OH 44907-2451 |
Second Address | Mansfield, OH 44907-2451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 07/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0124449 | (05) | OH |
E42387 | (02) | OH |