Healthcare Provider Details

I. General information

NPI: 1205028040
Provider Name (Legal Business Name): STEPHEN A. SCHEMENAUER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 01/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 EMERSON AVE
PARKERSBURG WV
26104-2519
US

IV. Provider business mailing address

906 WARREN ST
MARIETTA OH
45750-1955
US

V. Phone/Fax

Practice location:
  • Phone: 304-428-1900
  • Fax: 304-428-1976
Mailing address:
  • Phone: 740-525-8664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberWV01039
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: