Provider Demographics
NPI:1730313990
Name:SCHWEGMAN, MICHELE LYNN (PA)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LYNN
Last Name:SCHWEGMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N LOCUST ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:OXFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45056-1192
Mailing Address - Country:US
Mailing Address - Phone:513-523-2340
Mailing Address - Fax:513-523-5080
Practice Address - Street 1:10 N LOCUST ST
Practice Address - Street 2:SUITE D
Practice Address - City:OXFORD
Practice Address - State:OH
Practice Address - Zip Code:45056-1192
Practice Address - Country:US
Practice Address - Phone:513-523-2340
Practice Address - Fax:513-523-5080
Is Sole Proprietor?:No
Enumeration Date:2009-05-03
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50000716363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0111824Medicaid
OH0111824Medicaid