Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MB58906 | NJ |
NPI | 1992737175 |
---|---|
Provider Name | Henry R. Schuitema |
First Address | Woodbury, NJ 08096-2739 |
Second Address | Stratford, NJ 08084-1327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 17/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5399203 | (05) | NJ |
F52851 | (02) |