Provider Demographics
NPI:1144223025
Name:SCHUTTE, TERESA J (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:J
Last Name:SCHUTTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6939 COX RD STE 350
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45069-7595
Mailing Address - Country:US
Mailing Address - Phone:513-564-1600
Mailing Address - Fax:513-564-1624
Practice Address - Street 1:6939 COX RD STE 350
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45069-7595
Practice Address - Country:US
Practice Address - Phone:513-564-1600
Practice Address - Fax:513-564-1624
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35073852S207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100242580Medicaid
OH2022126OtherAETNA
OH2046726Medicaid
OH000000021102OtherANTHEM
OH288140OtherAMERIGROUP
OH73852OtherHUMANA
OH0702029OtherUNITED HEALTHCARE
OH160040699OtherMEDICARE RAILROAD
OH311575051034OtherCARESOURCE
OH280703289011OtherMEDICAL MUTUAL
OHH022101Medicare PIN
OH311575051034OtherCARESOURCE
OH160040699OtherMEDICARE RAILROAD
OHSC0850078Medicare PIN