MEDICARE: NATHANIEL SCHUMM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	152W00000X	Optometrist	OPT.007162	OH

General Provider Information

NPI Number	:	1528763182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHANIEL SCHUMM

Provider Business Mailing Address
First Line	:	12421 COUNTY ROAD P3
Second Line	:
City	:	NAPOLEON
State	:	OH
Zip	:	43545-9486
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3880 PAXTON AVE STE F
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-2372
Country	:	US
Telephone Number	:	513-826-5726
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2023
Last Update Date	:	05/30/2023

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Directions to “ NATHANIEL SCHUMM ” Practice Location

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