Provider Demographics
NPI:1215938089
Name:SCHUMAN, ELLIOT HOWARD (MD)
Entity type:Individual
Prefix:
First Name:ELLIOT
Middle Name:HOWARD
Last Name:SCHUMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2214
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32781-2214
Mailing Address - Country:US
Mailing Address - Phone:321-269-0747
Mailing Address - Fax:321-269-8485
Practice Address - Street 1:825 CENTURY MEDICAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2113
Practice Address - Country:US
Practice Address - Phone:321-269-0747
Practice Address - Fax:321-269-8485
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME036864207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D63571Medicare UPIN
95697Medicare ID - Type Unspecified