Provider Demographics
NPI:1851417893
Name:SCHIEMAN, WESLEY MICHAEL (RPH)
Entity Type:Individual
Prefix:
First Name:WESLEY
Middle Name:MICHAEL
Last Name:SCHIEMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 LOREE RD.
Mailing Address - Street 2:
Mailing Address - City:APPLEGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48401-9726
Mailing Address - Country:US
Mailing Address - Phone:810-633-9545
Mailing Address - Fax:
Practice Address - Street 1:6480 MAIN ST
Practice Address - Street 2:
Practice Address - City:CASS CITY
Practice Address - State:MI
Practice Address - Zip Code:48726-1143
Practice Address - Country:US
Practice Address - Phone:989-872-3613
Practice Address - Fax:989-872-5149
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302030768OtherPHARMACIST LICENSE