1649380619 NPI number — MICHAEL SCHMERLER MD

Table of content: MICHAEL SCHMERLER MD (NPI 1649380619)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649380619 NPI number — MICHAEL SCHMERLER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMERLER
Provider First Name:
MICHAEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649380619
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4805 MONTGOMERY RD
Provider Second Line Business Mailing Address:
SUITE 150
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45212-2198
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-961-5558
Provider Business Mailing Address Fax Number:
513-961-1912

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4805 MONTGOMERY RD
Provider Second Line Business Practice Location Address:
SUITE 410
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45212-2198
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-241-2370
Provider Business Practice Location Address Fax Number:
513-241-6053
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  35-041637 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0800X , with the licence number: 21271 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1878541-002 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 641743 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000019824 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0373304 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 05-20150 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200070320A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 311412447066 . This is a "CARESOURCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64761984 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 13887 . This is a "NATIONWIDE HEALTH PLANS" identifier . This identifiers is of the category "OTHER".




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