Individual
CARMEN R. SCHAUMBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7925 YOUREE DRIVE, SUITE 200, SHREVEPORT, LA 71105-5134
(318) 212-3610
(318) 212-3709
Mailing address
7925 YOUREE DRIVE, SUITE 200, SHREVEPORT, LA 71105-5134
(318) 212-3610
(318) 212-3709
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200344.RX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2100912
—
LA
01
—
276624YP55
MEDICARE PTAN
LA
Enumeration date
01/29/2010
Last updated
05/16/2013
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