Provider Demographics
NPI:1497737589
Name:SCHUELLER, DEAN R (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:R
Last Name:SCHUELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 0446 24 FRANK LLOYD WRIGHT DR.
Mailing Address - Street 2:LOBBY J IHA
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:5315 ELLIOTT DR
Practice Address - Street 2:SUITE 304
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-8634
Practice Address - Country:US
Practice Address - Phone:734-712-0655
Practice Address - Fax:734-712-0611
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082742207X00000X
IL036079166207X00000X
WI36624020207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2008101531OtherBLUE CROSS BLUE SHIELD
MI137413OtherCARE CHOICES
MI4774261Medicaid
MI2008101531OtherBLUE CROSS BLUE SHIELD
MI4774261Medicaid