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Individual

MARK D SCHAMBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CAA

Contact information

Practice address
11141 PARKVIEW PLAZA DR STE 200, FORT WAYNE, IN 46845-1714
(260) 425-6030
(260) 425-6028
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
28513404
MI
367H00000X
Anesthesiologist Assistant
Primary
75000042A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102529670
ANTHEM PTAN
IN
Enumeration date
03/20/2019
Last updated
05/14/2025
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