Provider Demographics
NPI:1356387633
Name:SCHLUDE, MICHAEL J (MPT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:SCHLUDE
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 INNOVATION DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15717-8096
Mailing Address - Country:US
Mailing Address - Phone:724-343-4060
Mailing Address - Fax:724-343-4069
Practice Address - Street 1:311 MARKET ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5428
Practice Address - Country:US
Practice Address - Phone:570-718-0933
Practice Address - Fax:570-718-0938
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013719L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
446232OtherHEALTH AMERICA ASSURANCE
820712OtherFIRST PRIORITY
0911678OtherBLUE SHIELD
820714OtherFIRST PRIORITY
444143OtherHEALTH AMERICA ASSURANCE
444090OtherHEALTH AMERICA ASSURANCE
820713OtherFIRST PRIORITY