Provider Demographics
NPI:1689769838
Name:LAWRENCE I. SCHMETTERER, MD, FACS, INC.
Entity Type:Organization
Organization Name:LAWRENCE I. SCHMETTERER, MD, FACS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:I
Authorized Official - Last Name:SCHMETTERER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-743-3604
Mailing Address - Street 1:20 OHLTOWN RD
Mailing Address - Street 2:STE. 206
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2331
Mailing Address - Country:US
Mailing Address - Phone:330-743-3604
Mailing Address - Fax:
Practice Address - Street 1:20 OHLTOWN RD
Practice Address - Street 2:STE. 206
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2331
Practice Address - Country:US
Practice Address - Phone:330-743-3604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0969073Medicaid
OH9268301Medicare ID - Type Unspecified