Provider Demographics
NPI:1457339343
Name:SCHUMACHER, SCOTT ANDREW
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANDREW
Last Name:SCHUMACHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W168S7012 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-9441
Mailing Address - Country:US
Mailing Address - Phone:414-422-0569
Mailing Address - Fax:
Practice Address - Street 1:4850 S 74TH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-4359
Practice Address - Country:US
Practice Address - Phone:414-282-3308
Practice Address - Fax:414-325-8770
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2774152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist