Provider Demographics
NPI:1255547576
Name:SCHUMER, CHARLES MARCUS (DDS DENTIST)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:MARCUS
Last Name:SCHUMER
Suffix:
Gender:M
Credentials:DDS DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-3651
Mailing Address - Country:US
Mailing Address - Phone:989-790-6700
Mailing Address - Fax:989-790-6724
Practice Address - Street 1:3066 DAVENPORT AVE
Practice Address - Street 2:
Practice Address - City:SAGNIAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3651
Practice Address - Country:US
Practice Address - Phone:989-790-6700
Practice Address - Fax:989-790-6724
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010111861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIBS4703864OtherDEA NUMBER