Healthcare Provider Details

I. General information

NPI: 1083671184
Provider Name (Legal Business Name): ERIC ANDREW SCHAUB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1492 EAST BROAD STREET
COLUMBUS OH
43205
US

IV. Provider business mailing address

1492 EAST BROAD STREET
COLUMBUS OH
43205
US

V. Phone/Fax

Practice location:
  • Phone: 614-257-3559
  • Fax: 614-257-2450
Mailing address:
  • Phone: 614-257-3559
  • Fax: 614-257-2450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35056158
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number35056158
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: