Provider Demographics
NPI:1093876807
Name:SCHUMACHER, MARK DAVID (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:DAVID
Last Name:SCHUMACHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8724 BOURGADE AVE.
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1440
Mailing Address - Country:US
Mailing Address - Phone:913-299-6000
Mailing Address - Fax:913-721-1226
Practice Address - Street 1:8724 BOURGADE AVE.
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1440
Practice Address - Country:US
Practice Address - Phone:913-299-6000
Practice Address - Fax:913-599-3673
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSS370000Medicare ID - Type UnspecifiedMEDICARE PART B PROVIDER