Healthcare Provider Details

I. General information

NPI: 1538397534
Provider Name (Legal Business Name): ROSEANN LISA SCHELLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 2008
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVE ML 2008
CINCINNATI OH
45229
US

V. Phone/Fax

Practice location:
  • Phone: 314-719-7745
  • Fax:
Mailing address:
  • Phone: 314-719-7745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.098739
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2015014692
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-37977
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number35.098739
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: