Provider Demographics
NPI:1881642403
Name:SCHUURMAN, EDWARD T (PA-C)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:T
Last Name:SCHUURMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:601 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2332
Practice Address - Country:US
Practice Address - Phone:717-765-5088
Practice Address - Fax:717-765-5066
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA050733363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25-1716306OtherDEVON
PA120420417OtherDEPT OF LABOR
PA25-1716306OtherINTERGROUP
PA50075602OtherCAPITAL BLUECROSS
PAMA050733OtherLICENSE
PA103181922Medicaid
PAP00804840OtherRAILROAD MEDICARE
PA50075602OtherCAPITAL BLUECROSS
PA25-1716306OtherDEVON
PA122360LN7Medicare PIN