Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 34005759 | OH |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 34.005759 | OH |
NPI | 1447254321 |
---|---|
Provider Name | Paul T Scheatzle |
First Address | Canton, OH 44718-3645 |
Second Address | Canton, OH 44718-3645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2023410 | (05) | OH |
G50706 | (02) | OH |