1356387633 NPI number — MR. MICHAEL J SCHLUDE MPT

Table of content: DR. ISIK TURKER MD (NPI 1003075763)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356387633 NPI number — MR. MICHAEL J SCHLUDE MPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHLUDE
Provider First Name:
MICHAEL
Provider Middle Name:
J
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MPT
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:
1356387633
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
430 INNOVATION DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLAIRSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15717-8096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-343-4060
Provider Business Mailing Address Fax Number:
724-343-4069

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
311 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-5428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-718-0933
Provider Business Practice Location Address Fax Number:
570-718-0938
Provider Enumeration Date:
06/22/2006

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: 225100000X , with the licence number:  PT013719L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 446232 . This is a "HEALTH AMERICA ASSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 820712 . This is a "FIRST PRIORITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0911678 . This is a "BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 820714 . This is a "FIRST PRIORITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 444143 . This is a "HEALTH AMERICA ASSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 444090 . This is a "HEALTH AMERICA ASSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 820713 . This is a "FIRST PRIORITY" identifier . This identifiers is of the category "OTHER".




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