1780680249 NPI number — DR. MONICA JEAN SCHUGEL D.C.

Table of content: DAIJAH POWERS (NPI 1508388687)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780680249 NPI number — DR. MONICA JEAN SCHUGEL D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHUGEL
Provider First Name:
MONICA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

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:
1780680249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1706 LOR RAY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH MANKATO
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56003-1939
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-385-1015
Provider Business Mailing Address Fax Number:
507-388-8001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1706 LOR RAY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH MANKATO
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56003-1939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-385-1015
Provider Business Practice Location Address Fax Number:
507-388-8001
Provider Enumeration Date:
06/21/2005

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: 111N00000X , with the licence number:  4317 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6167123 . This is a "STATE TAX ID #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 651095 . This is a "CHIRO CARE #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 044L5SC . This is a "BC/BS GROUP #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 044L6SC . This is a "BC/BS INDIVIDUAL #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 74-3067606 . This is a "FED. TAX ID#" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 560065100 . This is a "MN CARE #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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