Provider Demographics
NPI:1124066600
Name:SCHUENEMAN, LOUIS (OD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:SCHUENEMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 S AIRPORT RD W
Mailing Address - Street 2:SUITE 146
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-8117
Mailing Address - Country:US
Mailing Address - Phone:231-941-7788
Mailing Address - Fax:231-941-0893
Practice Address - Street 1:6800 EASTMAN AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-7810
Practice Address - Country:US
Practice Address - Phone:989-839-5858
Practice Address - Fax:989-839-8440
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILS002248152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MILS002248OtherLICENSE
T33196Medicare UPIN