Provider Demographics
NPI:1982612792
Name:SCHUMANN, KEITH W (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:W
Last Name:SCHUMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 BULIFANTS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5738
Mailing Address - Country:US
Mailing Address - Phone:757-564-1200
Mailing Address - Fax:757-564-0034
Practice Address - Street 1:302 BULIFANTS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5738
Practice Address - Country:US
Practice Address - Phone:757-564-1200
Practice Address - Fax:757-564-0034
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101226511174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA542014335OtherTRICARE STANDARD
VA542014335OtherVIRGINIA HEALTH NETWORK
VA285595OtherANTHEM BC/BS
VA37187OtherOPTIMA PPO
VA542014335OtherWPS TRICARE
VA542014335OtherVIRGINIA HEALTH NETWORK
VA070015852Medicare ID - Type UnspecifiedRAILROAD PLAN
VAH31874Medicare UPIN