Provider Demographics
NPI:1013093871
Name:SCHNULO, STEPHEN E (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:E
Last Name:SCHNULO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 E WILSON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2379
Mailing Address - Country:US
Mailing Address - Phone:614-885-7464
Mailing Address - Fax:614-885-7447
Practice Address - Street 1:89 E WILSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2379
Practice Address - Country:US
Practice Address - Phone:614-885-7464
Practice Address - Fax:614-885-7447
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4230152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0683261Medicare ID - Type UnspecifiedMEDICARE
OHU08712Medicare UPIN