Provider Demographics
NPI:1659376242
Name:SCHORR, DAVID MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:SCHORR
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 1:1472 SOLUTIONS CTR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1004
Mailing Address - Country:US
Mailing Address - Phone:513-557-3333
Mailing Address - Fax:513-557-3332
Practice Address - Street 1:3131 QUEEN CITY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-2316
Practice Address - Country:US
Practice Address - Phone:513-557-3333
Practice Address - Fax:513-557-3332
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083421207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64076987Medicaid
IN200461930Medicaid
OH2444288Medicaid
IN200461930Medicaid
OH2444288Medicaid
OH4123743Medicare PIN
OH0063540Medicare PIN
NCP00721345Medicare PIN