1508832981 NPI number — DAVID BRIAN SCHNITZER MD

Table of content: DAVID BRIAN SCHNITZER MD (NPI 1508832981)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508832981 NPI number — DAVID BRIAN SCHNITZER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHNITZER
Provider First Name:
DAVID
Provider Middle Name:
BRIAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508832981
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6591 W CENTRAL AVE
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43617-1087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-517-6599
Provider Business Mailing Address Fax Number:
419-517-0503

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
575 CHARRING CROSS DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
WESTERVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43081-4901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-895-0679
Provider Business Practice Location Address Fax Number:
614-895-0781
Provider Enumeration Date:
02/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207WX0107X , with the licence number:  35066402 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207W00000X , with the licence number: 35066402 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 341196311 . This is a "TAX IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000026350 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: SC0763121 . This is a "PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0783020 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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