1376628974 NPI number — DR. AARON JOEL SCHUENEMAN M.D.

Table of content: MR. JON F FOY MD (NPI 1699722801)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376628974 NPI number — DR. AARON JOEL SCHUENEMAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHUENEMAN
Provider First Name:
AARON
Provider Middle Name:
JOEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1376628974
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1835 SAVOY DR
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30341-1072
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
706-835-2235
Provider Business Mailing Address Fax Number:
706-835-1706

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 DEEP SOUTH FARM RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
BLAIRSVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30512-2218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-835-2235
Provider Business Practice Location Address Fax Number:
706-835-1706
Provider Enumeration Date:
10/25/2006

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: 207RH0003X , with the licence number:  075888 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 202I838480 . This is a "MEDICARE PTAN" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 003177299B , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003177299A , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 320138601 (MDACC) , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8DV857 . This is a "BCBS (MDACC)" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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