1821017476 NPI number — MRS. TAMARA SCHWING C.N.P.

Table of content: MRS. TAMARA SCHWING C.N.P. (NPI 1821017476)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821017476 NPI number — MRS. TAMARA SCHWING C.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWING
Provider First Name:
TAMARA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
C.N.P.
Provider Gender Code:
F

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:
1821017476
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3621 NELSON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RISING SUN
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47040-9226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-438-2212
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2314 AUBURN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219-2802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-721-7635
Provider Business Practice Location Address Fax Number:
513-721-2313
Provider Enumeration Date:
07/18/2006

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: 363LW0102X , with the licence number:  NP07381 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2625216 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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