Individual
DR. TIMOTHY RAYMOND SCHMAKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
31100 TELEGRAPH RD, SUITE 100, BINGHAM FARMS, MI 48025-4363
(248) 642-2115
(248) 642-6387
Mailing address
31100 TELEGRAPH RD, SUITE 100, BINGHAM FARMS, MI 48025-4363
(248) 642-2115
(248) 642-6387
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
16953
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
290106953
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0N36170
MEDICARE PTAN
—
05
—
104370251
—
MI
05
—
124370251
—
MI
Enumeration date
08/31/2006
Last updated
07/22/2014
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