Provider Demographics
NPI:1023149051
Name:PM SCHAP MD PC
Entity type:Organization
Organization Name:PM SCHAP MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:MARLE
Authorized Official - Last Name:SCHAP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-486-3433
Mailing Address - Street 1:9460 W PEORIA AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-6300
Mailing Address - Country:US
Mailing Address - Phone:623-486-3433
Mailing Address - Fax:623-486-0290
Practice Address - Street 1:9460 W PEORIA AVE
Practice Address - Street 2:D
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6300
Practice Address - Country:US
Practice Address - Phone:623-486-3433
Practice Address - Fax:623-486-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15371207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D65080Medicare UPIN
353328458Medicare ID - Type Unspecified