Provider Demographics
NPI:1518385509
Name:STECHSCHULTE, CYNTHIA L (PA)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:STECHSCHULTE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-2401
Mailing Address - Country:US
Mailing Address - Phone:937-498-5334
Mailing Address - Fax:937-494-5914
Practice Address - Street 1:326 N. MAIN STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:MINSTER
Practice Address - State:OH
Practice Address - Zip Code:45865
Practice Address - Country:US
Practice Address - Phone:419-501-1530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0040000363AM0700X
363AS0400X
OH50.004000RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical