Individual
SAMUEL OWENS SCHUMANN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
104 FUNK AVE, SAINT STEPHEN, SC 29479-3383
(843) 567-3206
(843) 567-3287
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13550
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135507
—
SC
01
—
GP3821
MEDICAID GROUP LIVE OAK
SC
01
—
GPPA0169
MEDICAID GROUP
SC
01
—
P00449862
RR MEDICARE
SC
Enumeration date
06/17/2005
Last updated
06/10/2021
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