Provider Demographics
NPI:1831290857
Name:SCHOONMAN, PAUL M (DC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:SCHOONMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 DUNDEE PARK DR
Mailing Address - Street 2:SUITES 1 AND 2
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3726
Mailing Address - Country:US
Mailing Address - Phone:978-474-4122
Mailing Address - Fax:978-474-0171
Practice Address - Street 1:1 DUNDEE PARK DR
Practice Address - Street 2:SUITES 1 AND 2
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3726
Practice Address - Country:US
Practice Address - Phone:978-474-4122
Practice Address - Fax:978-474-0171
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0767240OtherCIGNA HEALTHCARE
MA1612573Medicaid
MA4400157OtherUNITED HEALTHCARE
MA2060125OtherAETNA/US HEALTHCARE
MDY36239OtherBLUECROSS BLUESHIELD
MA350270OtherHARVARD PILGRIM
MA764045OtherTUFTS HEALTH PLAN
MAY36239Medicare ID - Type Unspecified