| Southeast Missouri Oral & Maxillofacial Surgery | |
|
66 Doctors Park Cape Girardeau MO 63703-4928 | |
| (573) 334-5566 | |
| (573) 334-9004 |
| Full Name | Southeast Missouri Oral & Maxillofacial Surgery |
|---|---|
| Speciality | Dentist |
| Location | 66 Doctors Park, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Steve Schoolman (OWNER) |
| Authorized Official Contact | 5733345566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Missouri Oral & Maxillofacial Surgery 66 Doctors Park Cape Girardeau MO 63703-4928 Ph: (573) 334-5566 | Southeast Missouri Oral & Maxillofacial Surgery 66 Doctors Park Cape Girardeau MO 63703-4928 Ph: (573) 334-5566 |
| NPI Number | 1114217585 |
|---|---|
| Provider Enumeration Date | 04/19/2011 |
| Last Update Date | 04/10/2024 |
| Medicare PECOS PAC ID | 2769650647 |
|---|---|
| Medicare Enrollment ID | O20110720000254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114217585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 2003012137 (Missouri) | Primary |
| Provider Name | Steven R Schoolman |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1093862997 PECOS PAC ID: 7113195009 Enrollment ID: I20110720000275 |
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