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Individual

COREY B SCHAEDIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 942-9610
Mailing address
PO BOX Q, GRAND RAPIDS, MI 49501-4917
(800) 968-6866

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601004511
MI
363AM0700X
Medical Physician Assistant
Primary
5601004511
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00321467
RAILROAD MEDICARE
Enumeration date
08/12/2006
Last updated
03/04/2008
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