Provider Demographics
NPI:1689032450
Name:SCHUMACHER, CARMELLA P (PA)
Entity Type:Individual
Prefix:
First Name:CARMELLA
Middle Name:P
Last Name:SCHUMACHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 MAIDEN LN SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-4907
Mailing Address - Country:US
Mailing Address - Phone:757-876-6437
Mailing Address - Fax:
Practice Address - Street 1:46 WESLEY RD
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24083-3082
Practice Address - Country:US
Practice Address - Phone:540-591-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-005227363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical