Healthcare Provider Details

I. General information

NPI: 1144223025
Provider Name (Legal Business Name): TERESA J SCHUTTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6939 COX RD STE 350
LIBERTY TWP OH
45069-7595
US

IV. Provider business mailing address

6939 COX RD STE 350
LIBERTY TWP OH
45069-7595
US

V. Phone/Fax

Practice location:
  • Phone: 513-564-1600
  • Fax: 513-564-1624
Mailing address:
  • Phone: 513-564-1600
  • Fax: 513-564-1624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35073852S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: