Provider Demographics
NPI:1164686440
Name:SHUCHMAN, DEVON NEWMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:NEWMAN
Last Name:SHUCHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5333 MCAULEY DR
Mailing Address - Street 2:SUITE 2009
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1014
Mailing Address - Country:US
Mailing Address - Phone:734-712-0077
Mailing Address - Fax:734-712-0088
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:SUITE 2009
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1014
Practice Address - Country:US
Practice Address - Phone:734-712-0077
Practice Address - Fax:734-712-0088
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091649208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1164686440Medicaid
MI250110020OtherBCBS OF MICHIGAN
MI0N12520010Medicare PIN