Provider Demographics
NPI:1427160068
Name:SCHMOKE, RAYMOND EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:EDWARD
Last Name:SCHMOKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAYMOND
Other - Middle Name:EF
Other - Last Name:SCHMOKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1806 EAST PARKDALE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660
Mailing Address - Country:US
Mailing Address - Phone:231-723-3567
Mailing Address - Fax:231-723-1767
Practice Address - Street 1:924 N.HOWE ST.
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461
Practice Address - Country:US
Practice Address - Phone:910-457-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-00987207R00000X
MI4301047408207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1748544Medicaid
MI1748544Medicaid
B44063Medicare UPIN