Provider Demographics
NPI:1700942133
Name:PERSONAL CARE PHYSICIAN PLLC
Entity Type:Organization
Organization Name:PERSONAL CARE PHYSICIAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:SCHINDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-912-1919
Mailing Address - Street 1:26179 NOVI RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1140
Mailing Address - Country:US
Mailing Address - Phone:248-912-1919
Mailing Address - Fax:248-912-1915
Practice Address - Street 1:26179 NOVI RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1140
Practice Address - Country:US
Practice Address - Phone:248-912-1919
Practice Address - Fax:248-912-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301407358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301407358OtherMI STATE LICENSE NUMBER
MIDS407358OtherMEDICAL LICENSE NUMBER
MI0806357571OtherBLUE CROSS PIN
MIDS407358OtherMEDICAL LICENSE NUMBER