Provider Demographics
NPI:1790972206
Name:SCHIMAN, DAVID WAYNE (MAC, RAC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
Last Name:SCHIMAN
Suffix:
Gender:M
Credentials:MAC, RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 LYCEUM AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-3420
Mailing Address - Country:US
Mailing Address - Phone:267-417-0147
Mailing Address - Fax:267-417-0147
Practice Address - Street 1:445 LYCEUM AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-3420
Practice Address - Country:US
Practice Address - Phone:267-417-0147
Practice Address - Fax:267-417-0147
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAKO000609171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist