Provider Demographics
NPI:1396944484
Name:DOUGLAS R SCHUMACHER MD LLC
Entity type:Organization
Organization Name:DOUGLAS R SCHUMACHER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BELLOMY
Authorized Official - Suffix:
Authorized Official - Credentials:RHIT
Authorized Official - Phone:614-299-9909
Mailing Address - Street 1:PO BOX 1163
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43216-1163
Mailing Address - Country:US
Mailing Address - Phone:614-299-9909
Mailing Address - Fax:614-299-9919
Practice Address - Street 1:1275 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 223
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3119
Practice Address - Country:US
Practice Address - Phone:614-299-9909
Practice Address - Fax:614-299-9919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062976S261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9341981Medicare PIN