Provider Demographics
NPI:1427007608
Name:KEVEN C SCHATTNER DO PC
Entity Type:Organization
Organization Name:KEVEN C SCHATTNER DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHATTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-345-1005
Mailing Address - Street 1:621 COURT ST
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661
Mailing Address - Country:US
Mailing Address - Phone:989-345-1005
Mailing Address - Fax:989-345-1103
Practice Address - Street 1:621 COURT ST
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661
Practice Address - Country:US
Practice Address - Phone:989-345-1005
Practice Address - Fax:989-345-1103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0256500165OtherBXBS
MI4406283Medicaid
H61467Medicare UPIN