Provider Demographics
NPI:1063566826
Name:SCHEUFLER, TARA J (DO)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:J
Last Name:SCHEUFLER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2200 PHILADELPHIA DR
Mailing Address - Street 2:SUITE 441
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-1840
Mailing Address - Country:US
Mailing Address - Phone:937-734-2230
Mailing Address - Fax:937-567-4186
Practice Address - Street 1:2200 PHILADELPHIA DR
Practice Address - Street 2:SUITE 441
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406
Practice Address - Country:US
Practice Address - Phone:937-734-2230
Practice Address - Fax:937-567-4186
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2018-06-06
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Provider Licenses
StateLicense IDTaxonomies
OH08940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014618000002Medicaid
OH2892099Medicaid
PA1014618000002Medicaid
OHH010450Medicare PIN