Provider Demographics
NPI:1447430566
Name:ERIC K SCHUBERT, DPM, LLC
Entity Type:Organization
Organization Name:ERIC K SCHUBERT, DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ERIC K SCHUBERT, DPM
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:143-953-5176
Mailing Address - Street 1:2875 RAVINE WAY
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3507
Mailing Address - Country:US
Mailing Address - Phone:143-953-5176
Mailing Address - Fax:866-244-0657
Practice Address - Street 1:2875 RAVINE WAY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3507
Practice Address - Country:US
Practice Address - Phone:614-395-3517
Practice Address - Fax:866-244-0657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003098S213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU85589Medicare UPIN
ER9344351Medicare PIN