Provider Demographics
NPI:1699713479
Name:SCHULER, MARK (PHD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:SCHULER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3812 THOMAS AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1232
Mailing Address - Country:US
Mailing Address - Phone:612-418-4700
Mailing Address - Fax:612-926-2135
Practice Address - Street 1:4601 EXCELSIOR BLVD
Practice Address - Street 2:SUITE 301B
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-4960
Practice Address - Country:US
Practice Address - Phone:612-435-0413
Practice Address - Fax:877-704-1444
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0851103G00000X, 103TC0700X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0102001OtherPREFERRED ONE
MN1940623OtherAMERICA'S PPO
MN68G44SCOtherBCBS
MNHP39202OtherHEALTH PARTNERS
MN61-30224OtherMEDICA (CHOICE)
MN61-00964OtherUBH-MEDICA
MN113580OtherUCARE
MN834550300Medicaid
MN61-620224OtherUBH
MN68G44SCOtherBHSI
MN6G612SCOtherBLUE CROSS
MN834550300Medicaid