Provider Demographics
NPI:1326067349
Name:SCHUMACHER, KIMBERLY YU (DO)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:YU
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:YU
Other - Last Name:MUDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1919 LATHROP STREET
Mailing Address - Street 2:SUITE 222
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-5942
Mailing Address - Country:US
Mailing Address - Phone:907-456-8191
Mailing Address - Fax:907-456-8192
Practice Address - Street 1:1919 LATHROP STREET
Practice Address - Street 2:SUITE 222
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-5942
Practice Address - Country:US
Practice Address - Phone:907-456-8191
Practice Address - Fax:907-456-8192
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4436207V00000X
AK6835207V00000X
AKMED06835207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKID# 6401735OtherCIGNA
AKID#7037487OtherAETNA
AK1010275Medicaid
AKMD1487Medicaid
AKMD1487Medicaid
AK0361450001Medicare NSC
AKBM9860758OtherDEA
AKID#7037487OtherAETNA