Provider Demographics
NPI:1548243900
Name:SCHEIDLER, STANLEY E (DO)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:E
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 1:543 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-3033
Mailing Address - Country:US
Mailing Address - Phone:513-737-0257
Mailing Address - Fax:513-737-3627
Practice Address - Street 1:543 PARK AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-3033
Practice Address - Country:US
Practice Address - Phone:513-737-0257
Practice Address - Fax:513-737-3627
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-008570251S00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2607094Medicaid
OH2607094Medicaid
OHH300050Medicare PIN
OHP01431633Medicare PIN