Provider Demographics
NPI:1174562656
Name:SCHUMACHER, JOEL MARK (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:MARK
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 1:1105 CUMBERLAND XING
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2356
Mailing Address - Country:US
Mailing Address - Phone:219-440-4835
Mailing Address - Fax:866-699-6936
Practice Address - Street 1:1105 CUMBERLAND XING
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2356
Practice Address - Country:US
Practice Address - Phone:219-440-4835
Practice Address - Fax:866-699-6936
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01041608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200045380AMedicaid
IN000000216159OtherBCBS
IN080181782Medicare PIN
IN200045380AMedicaid
ING12536Medicare UPIN