Provider Demographics
NPI:1346973377
Name:SCHARDT, MARYCLARE KASTELIC
Entity Type:Individual
Prefix:
First Name:MARYCLARE
Middle Name:KASTELIC
Last Name:SCHARDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 OAK ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3921
Mailing Address - Country:US
Mailing Address - Phone:216-785-1990
Mailing Address - Fax:
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-584-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program