Provider Demographics
NPI:1528044849
Name:SCHUMACHER, DOUGLAS R (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:R
Last Name:SCHUMACHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6488 E MAIN ST STE 110
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-7310
Mailing Address - Country:US
Mailing Address - Phone:614-860-8080
Mailing Address - Fax:614-860-8061
Practice Address - Street 1:6488 E MAIN ST STE 110
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068
Practice Address - Country:US
Practice Address - Phone:614-860-8080
Practice Address - Fax:614-860-8061
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062976S207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000330559OtherBC/BS
OH0922158Medicaid
OH0922158Medicaid
OHSC0738564Medicare ID - Type Unspecified