Provider Demographics
NPI:1003204199
Name:SCHAD, JOSHUA DAVID (NP-C)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DAVID
Last Name:SCHAD
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 MEYER CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48838-2136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1576 W BLUEWATER HWY
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-8594
Practice Address - Country:US
Practice Address - Phone:616-527-6331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-26
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704243678363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner