Provider Demographics
NPI:1538142310
Name:SCHEIDLER, PETER A (DO)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:SCHEIDLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 SIARON WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-2684
Mailing Address - Country:US
Mailing Address - Phone:513-737-1500
Mailing Address - Fax:513-737-0255
Practice Address - Street 1:3515 SIARON WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-2684
Practice Address - Country:US
Practice Address - Phone:513-737-1500
Practice Address - Fax:513-737-0255
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-006722207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2160978Medicaid
OHP01431622Medicare PIN
OHH226351Medicare PIN
OHH01131Medicare UPIN
OH000000064366OtherANTHEM
OHH01131Medicare UPIN
OH06722-03OtherCHOICE CARE
OH283604OtherAMERIGROUP