Provider Demographics
NPI:1518139302
Name:TESSA B SCHISLER DO PLC
Entity Type:Organization
Organization Name:TESSA B SCHISLER DO PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE MANAGET
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-892-4586
Mailing Address - Street 1:701 E VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-4971
Mailing Address - Country:US
Mailing Address - Phone:989-892-4586
Mailing Address - Fax:989-892-2901
Practice Address - Street 1:701 E VERMONT ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-4971
Practice Address - Country:US
Practice Address - Phone:989-892-4586
Practice Address - Fax:989-892-2901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015867207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1021423OtherMCLAREN
MITS015867OtherBLUE CROSS
MI114900741Medicaid
MI01005206OtherHEALTHPLUS
MITS015867OtherBLUE CROSS
MI0P34480Medicare PIN