Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 4301059878 | MI |
NPI | 1013082759 |
---|---|
Provider Name | Lori Ann Schuh |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49503-2515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 17/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
130H264490 | BLUE CROSS-BLUE CROSS (01) | |
336324310 | (05) | MI |
F20438 | (02) | |
LS059878 | CHAMPUS-CHAMPUS (01) | |
LS059878 | COMMERCIAL-COMMERCIAL NUMBER (01) |