Provider Demographics
NPI: | 1487871224 |
---|---|
Name: | SCHUMACHER, KURT ROBERT (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | KURT |
Middle Name: | ROBERT |
Last Name: | SCHUMACHER |
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: | 3621 S STATE ST |
Mailing Address - Street 2: | 700 KMS PLACE |
Mailing Address - City: | ANN ARBOR |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48108 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 734-936-2047 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1500 E MEDICAL CENTER DR |
Practice Address - Street 2: | 11TH FLOOR C.S.MOTT CHILDRENS HOSPITAL ROOM 661 |
Practice Address - City: | ANN ARBOR |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48109-5204 |
Practice Address - Country: | US |
Practice Address - Phone: | 734-764-5176 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-04-20 |
Last Update Date: | 2012-08-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MI | 4301091629 | 208000000X, 2080P0202X |
390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2080P0202X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |