1699713479 NPI number — MARK SCHULER PH.D.

Table of content: MARK SCHULER PH.D. (NPI 1699713479)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699713479 NPI number — MARK SCHULER PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHULER
Provider First Name:
MARK
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.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:
1699713479
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3812 THOMAS AVE S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55410-1232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-418-4700
Provider Business Mailing Address Fax Number:
612-926-2135

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4601 EXCELSIOR BLVD
Provider Second Line Business Practice Location Address:
SUITE 301B
Provider Business Practice Location Address City Name:
ST LOUIS PARK
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55416-4960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-435-0413
Provider Business Practice Location Address Fax Number:
877-704-1444
Provider Enumeration Date:
06/03/2006

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: 103G00000X , with the licence number:  LP0851 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: LP0851 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TH0100X , with the licence number: LP0851 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0102001 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1940623 . This is a "AMERICA'S PPO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 68G44SC . This is a "BCBS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: HP39202 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 61-30224 . This is a "MEDICA (CHOICE)" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 61-00964 . This is a "UBH-MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 113580 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 834550300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 61-620224 . This is a "UBH" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 68G44SC . This is a "BHSI" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 6G612SC . This is a "BLUE CROSS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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