Provider Demographics
NPI:1023059128
Name:SCHUMPERT, JOHN C (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:SCHUMPERT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:210 E PINE ST
Mailing Address - Street 2:STE 100
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4533
Mailing Address - Country:US
Mailing Address - Phone:406-549-6520
Mailing Address - Fax:406-549-6797
Practice Address - Street 1:210 E PINE ST
Practice Address - Street 2:STE 100
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4533
Practice Address - Country:US
Practice Address - Phone:406-549-6520
Practice Address - Fax:406-549-6797
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MT84852083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTF80381Medicare UPIN