Healthcare Provider Details

I. General information

NPI: 1548243900
Provider Name (Legal Business Name): STANLEY E. SCHEIDLER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 PARK AVE
HAMILTON OH
45013-3033
US

IV. Provider business mailing address

543 PARK AVE
HAMILTON OH
45013-3033
US

V. Phone/Fax

Practice location:
  • Phone: 513-737-0257
  • Fax: 513-737-3627
Mailing address:
  • Phone: 513-737-0257
  • Fax: 513-737-3627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34-008570
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number34-008570
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: