Provider Demographics
NPI:1467663021
Name:STUART R SCHILLING DPM INC
Entity Type:Organization
Organization Name:STUART R SCHILLING DPM INC
Other - Org Name:ABC PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILLING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-755-2290
Mailing Address - Street 1:5969 E BROAD ST STE 407
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-1540
Mailing Address - Country:US
Mailing Address - Phone:614-755-2290
Mailing Address - Fax:614-755-6390
Practice Address - Street 1:5969 E BROAD ST STE 407
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1540
Practice Address - Country:US
Practice Address - Phone:614-755-2290
Practice Address - Fax:614-755-6390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1533213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2618528Medicaid
OH9264981Medicare PIN
OH2618528Medicaid