Provider Demographics
NPI:1336139997
Name:NEUSCHWANGER, SAMUEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:NEUSCHWANGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-2551
Mailing Address - Country:US
Mailing Address - Phone:419-232-5279
Mailing Address - Fax:419-232-5271
Practice Address - Street 1:1175 WESTWOOD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-2464
Practice Address - Country:US
Practice Address - Phone:419-238-3570
Practice Address - Fax:419-238-0366
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002056213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0480519Medicaid
OH480001126OtherRAILROAD MEDICARE
OH480001126OtherRAILROAD MEDICARE