1194758045 NPI number — DR. CARL J. SCHULER DO

Table of content: MR. KEITH MICHAEL MC AREE MA; CASAC (NPI 1720255136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194758045 NPI number — DR. CARL J. SCHULER DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHULER
Provider First Name:
CARL
Provider Middle Name:
J.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194758045
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
744 ROOSEVELT TRL
Provider Second Line Business Mailing Address:
SUITE 206
Provider Business Mailing Address City Name:
WINDHAM
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04062-5282
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-892-7006
Provider Business Mailing Address Fax Number:
207-892-2092

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
744 ROOSEVELT TRL
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
WINDHAM
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04062-5282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-892-7006
Provider Business Practice Location Address Fax Number:
207-892-2092
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207QG0300X , with the licence number:  1133DO , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: 1133 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 222480000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: D93051 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 001824 . This is a "ANTHEM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1043186 . This is a "AETNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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