Provider Demographics
NPI:1851616742
Name:SCHEIDLER, JOSHUA MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MICHAEL
Last Name:SCHEIDLER
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 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:1205 S MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-3677
Practice Address - Country:US
Practice Address - Phone:219-407-6307
Practice Address - Fax:219-933-2275
Is Sole Proprietor?:No
Enumeration Date:2010-04-02
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0055585207T00000X
CODR.0055585208100000X
IN01088274A208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO23877375Medicaid
CO026117OtherKAISER COMMERCIAL NUMBER
CO437091YK5YMedicare PIN