Provider Demographics
NPI:1225025943
Name:SCHAAK, PAUL HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HENRY
Last Name:SCHAAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8244 E US HIGHWAY 36
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9575
Mailing Address - Country:US
Mailing Address - Phone:317-272-7500
Mailing Address - Fax:317-272-7515
Practice Address - Street 1:8244 E US HIGHWAY 36
Practice Address - Street 2:SUITE 1100
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9575
Practice Address - Country:US
Practice Address - Phone:317-272-7500
Practice Address - Fax:317-272-7515
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2011-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01032085207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100063390AMedicaid
343800OMedicare PIN
C24362Medicare UPIN