Provider Demographics
NPI:1396813663
Name:SCHEITHAUER, RICHARD (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:SCHEITHAUER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5361 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3437
Mailing Address - Country:US
Mailing Address - Phone:440-282-7132
Mailing Address - Fax:
Practice Address - Street 1:5361 OBERLIN AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-3437
Practice Address - Country:US
Practice Address - Phone:440-282-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2022-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 4815111N00000X
OH1099111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1099OtherSTATE LICENSE ID #
OH0585719Medicaid
OH34165606000OtherWORKERS' COMPENSATION ID
34-1656020OtherTAXPAYER ID
FLCH4815OtherSTATE LICENSE ID #
SC0566002OtherMEDICARE INDIVIDUAL ID
OH0585719Medicaid