Provider Demographics
NPI:1679039788
Name:SCHUERGER, NATHAN DOUGLAS (MSHS, PA-C)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:DOUGLAS
Last Name:SCHUERGER
Suffix:
Gender:M
Credentials:MSHS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 KOLBE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-1652
Mailing Address - Country:US
Mailing Address - Phone:440-222-4970
Mailing Address - Fax:440-222-4971
Practice Address - Street 1:3600 KOLBE RD STE 100
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1652
Practice Address - Country:US
Practice Address - Phone:440-222-4970
Practice Address - Fax:440-222-4971
Is Sole Proprietor?:No
Enumeration Date:2019-02-13
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005878RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0338815Medicaid