MEDICARE: GRANT SANFORD SCHULERT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0216X	Pediatric Rheumatology Physician	35.121911	OH

General Provider Information

NPI Number	:	1033352059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRANT SANFORD SCHULERT M.D.

Provider Business Mailing Address
First Line	:	3333 BURNET AVE
Second Line	:	MLC 4010
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3026
Country	:	US
Telephone Number	:	513-636-4676
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 BURNET AVE
Second Line	:	MLC 4010
City	:	CINCINNATI
State	:	OH
Zip	:	45229-3026
Country	:	US
Telephone Number	:	513-636-4676
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2009
Last Update Date	:	03/14/2016

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