Provider Demographics
NPI:1720520554
Name:SCHABERL, MARISSA (MPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:
Last Name:SCHABERL
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8598 COUNTRYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-3430
Mailing Address - Country:US
Mailing Address - Phone:440-665-9578
Mailing Address - Fax:
Practice Address - Street 1:9501 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-3430
Practice Address - Country:US
Practice Address - Phone:216-445-4501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004875RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant