Provider Demographics
NPI:1063572840
Name:SCHUG, DAVID HERBERT (BS RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:HERBERT
Last Name:SCHUG
Suffix:
Gender:M
Credentials:BS RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4274 OAK ST.
Mailing Address - Street 2:P.O. BOX 732
Mailing Address - City:BRIDGMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49106
Mailing Address - Country:US
Mailing Address - Phone:269-465-3217
Mailing Address - Fax:269-465-3204
Practice Address - Street 1:612 SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:BERRIEN SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49103-1603
Practice Address - Country:US
Practice Address - Phone:269-471-5020
Practice Address - Fax:269-473-2566
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302410441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist