Healthcare Provider Details

I. General information

NPI: 1306912662
Provider Name (Legal Business Name): S C PEDIATRIC ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 LINCOLN WAY E
MASSILLON OH
44646-3722
US

IV. Provider business mailing address

3825 LINCOLN WAY E
MASSILLON OH
44646-3722
US

V. Phone/Fax

Practice location:
  • Phone: 330-478-0038
  • Fax: 330-477-1383
Mailing address:
  • Phone: 330-478-0038
  • Fax: 330-477-1383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LOUIS J SCHANER
Title or Position: PRESIDENT
Credential: DO
Phone: 330-478-0038