Provider Demographics
NPI:1295727832
Name:SCHULTE, ALLISON MB (OD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:MB
Last Name:SCHULTE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6770 DIXIE HWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2087
Mailing Address - Country:US
Mailing Address - Phone:248-922-1111
Mailing Address - Fax:248-922-9962
Practice Address - Street 1:6770 DIXIE HWY
Practice Address - Street 2:SUITE 203
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2087
Practice Address - Country:US
Practice Address - Phone:248-922-1111
Practice Address - Fax:248-922-9962
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003620152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOF36504Medicare ID - Type Unspecified
U44794Medicare UPIN
MIMI5082001Medicare PIN