Provider Demographics
NPI:1669543484
Name:SCHERMER, TRACY WARREN (MD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:WARREN
Last Name:SCHERMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20398 NEW GAMBIER RD
Mailing Address - Street 2:
Mailing Address - City:GAMBIER
Mailing Address - State:OH
Mailing Address - Zip Code:43022-9654
Mailing Address - Country:US
Mailing Address - Phone:740-427-3298
Mailing Address - Fax:740-233-3018
Practice Address - Street 1:1250 VERNONVIEW DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1447
Practice Address - Country:US
Practice Address - Phone:740-393-6200
Practice Address - Fax:740-393-6423
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-4001-S207QA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8006866108Medicaid