Provider Demographics
NPI:1780648923
Name:SCHAIBLE, PAMELA HUGHES (MD)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:HUGHES
Last Name:SCHAIBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6540 WINTON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1391
Mailing Address - Country:US
Mailing Address - Phone:513-981-4180
Mailing Address - Fax:513-541-3819
Practice Address - Street 1:2450 KIPLING AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6600
Practice Address - Country:US
Practice Address - Phone:513-557-7556
Practice Address - Fax:513-853-5394
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2018-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-068475207Q00000X
OH35068475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0172521Medicaid
OH278450Medicaid
OHG13118Medicare UPIN
G13118Medicare UPIN
SC08007282Medicare PIN
OH0172521Medicaid
SC08007282Medicare PIN
OH310843268027Medicare ID - Type UnspecifiedCARESOURCE