Provider Demographics
NPI:1033399969
Name:SCHUMACHER, JILL MONROE (PA-C)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MONROE
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:MONROE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:201 DEFENSE HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8902
Mailing Address - Country:US
Mailing Address - Phone:667-204-7000
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2000 MEDICAL PARKWAY
Practice Address - Street 2:STE 101
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3742
Practice Address - Country:US
Practice Address - Phone:410-295-8900
Practice Address - Fax:410-280-4701
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC03936363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC246796ZDTRMedicare PIN
MD246792ZDR9Medicare PIN
NJ118272TLMMedicare PIN