Provider Demographics
NPI:1760409387
Name:SCHUMAKER, JONATHON NORMAN (MD)
Entity Type:Individual
Prefix:
First Name:JONATHON
Middle Name:NORMAN
Last Name:SCHUMAKER
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 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-213-1500
Mailing Address - Fax:828-651-6570
Practice Address - Street 1:190 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28741-7600
Practice Address - Country:US
Practice Address - Phone:828-526-1200
Practice Address - Fax:828-526-1230
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI38636207P00000X
MI4301066056207P00000X, 207Q00000X
NC2016-02245207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1760409387Medicaid
MI1417961137OtherBCBSM - BRONSON
MI4859064Medicaid
MIP29950005Medicare PIN
MIM57720031Medicare PIN
MIC97618335 - BRONSONMedicare PIN
MI4859064Medicaid