Provider Demographics
NPI:1598705956
Name:SCHEIDLER MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:SCHEIDLER MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCHEIDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:513-737-1500
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:513-737-1500
Mailing Address - Fax:513-737-0255
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:513-737-1500
Practice Address - Fax:513-737-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-8570207Q00000X
OH34-00-6722207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2607094Medicaid
OH2160978Medicaid
OH2160978Medicaid
OHI33727Medicare UPIN
OHH01131Medicare UPIN
OH2607094Medicaid