Individual
MR. CHARLES GLENN SCHENK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, PA-C
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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