Provider Demographics
NPI:1679142848
Name:SCHOENMAKER, CHELSEA (PA)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:SCHOENMAKER
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11012 E 13 MILE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-2547
Mailing Address - Country:US
Mailing Address - Phone:586-573-6880
Mailing Address - Fax:586-582-5729
Practice Address - Street 1:11012 E 13 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2572
Practice Address - Country:US
Practice Address - Phone:586-573-6880
Practice Address - Fax:586-582-5729
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363AS0400X
MI5601010643363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical