Provider Demographics
NPI:1689230070
Name:SCHOTTSTAEDT, ARONNE MICHAEL
Entity Type:Individual
Prefix:MR
First Name:ARONNE
Middle Name:MICHAEL
Last Name:SCHOTTSTAEDT
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:AJ
Other - Middle Name:MICHAEL
Other - Last Name:SCHOTTSTAEDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2449 OVERLOOK RD APT 6
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2486
Mailing Address - Country:US
Mailing Address - Phone:707-776-7135
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:707-776-7135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-12
Last Update Date:2019-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHZ80299390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program