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Individual

MR. CHARLES GLENN SCHENK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, PA-C

Contact information

Practice address
601 JOHN ST, SUITE M424, KALAMAZOO, MI 49007-5341
(269) 349-3350
(269) 349-2403
Mailing address
601 JOHN ST, SUITE M424, KALAMAZOO, MI 49007-5341
(269) 349-3350
(269) 349-2403

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
363AS0400X
Surgical Physician Assistant
Primary
5601005872
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0C97618
BCBS
MI
01
1417961137
BLUE CROSS BLUE SHIELD
MI
Enumeration date
02/28/2007
Last updated
11/27/2023
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