Provider Demographics
NPI:1194144063
Name:SCHAUMBERG, JORDAN ENNS (MD)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ENNS
Last Name:SCHAUMBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:ALYSSA ANN
Other - Last Name:ENNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5324 MCFARLAND RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6864
Mailing Address - Country:US
Mailing Address - Phone:196-874-6889
Mailing Address - Fax:
Practice Address - Street 1:5324 MCFARLAND RD STE 300
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6864
Practice Address - Country:US
Practice Address - Phone:919-687-4688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-08
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-00680207V00000X
TXBP10049683207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology