Provider Demographics
NPI:1790351021
Name:SCHOTTEN, SAMUEL JEFFREY (DO)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:JEFFREY
Last Name:SCHOTTEN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:804 SERVICE RD STE A202
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-6546
Mailing Address - Fax:517-432-9460
Practice Address - Street 1:463 E CIRCLE DR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-7500
Practice Address - Country:US
Practice Address - Phone:517-884-6546
Practice Address - Fax:517-432-9460
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2024-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101028310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine