Provider Demographics
NPI:1295736221
Name:SCHOENBERGER, ALVIN MARK (MD)
Entity type:Individual
Prefix:
First Name:ALVIN
Middle Name:MARK
Last Name:SCHOENBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:46325 W. TWELVE MILE ROAD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377
Mailing Address - Country:US
Mailing Address - Phone:248-465-1200
Mailing Address - Fax:248-465-2850
Practice Address - Street 1:46325 W. TWELVE MILE ROAD
Practice Address - Street 2:SUITE 250
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377
Practice Address - Country:US
Practice Address - Phone:248-465-1200
Practice Address - Fax:248-465-1201
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301048984207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI450839010Medicaid
MID90105Medicare UPIN