Provider Demographics
NPI:1326075201
Name:SCHUM, DAVID EUGENE (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EUGENE
Last Name:SCHUM
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7391 HARTCREST LN
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4877
Mailing Address - Country:US
Mailing Address - Phone:615-337-0459
Mailing Address - Fax:
Practice Address - Street 1:520 HICKORY WOODS RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1540
Practice Address - Country:US
Practice Address - Phone:865-671-0109
Practice Address - Fax:865-671-0109
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.13006367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4104338OtherBLUE CROSS
TNP00261198OtherMEDICARE TRAVELERS
TN4104338OtherBLUECARE
TN3603728Medicaid
TN100048627OtherPHP TENNCARE
TN3603728Medicare PIN