Provider Demographics
NPI:1154424570
Name:SCHWETSCHENAU, PAUL ROBERT (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:ROBERT
Last Name:SCHWETSCHENAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4805 MONTGOMERY RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2198
Mailing Address - Country:US
Mailing Address - Phone:513-961-5558
Mailing Address - Fax:513-961-1912
Practice Address - Street 1:4805 MONTGOMERY RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2198
Practice Address - Country:US
Practice Address - Phone:513-791-6400
Practice Address - Fax:513-791-5306
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-038097207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000019550OtherANTHEM
13755OtherNATIONWIDE HEALTH PLANS
2558038-001OtherCIGNA
OH0286382Medicaid
641356OtherAETNA
06-20062OtherUNITED HEALTHCARE
IN200161680AMedicaid
KY64956048Medicaid
OH0286382Medicaid
13755OtherNATIONWIDE HEALTH PLANS
140004754Medicare ID - Type UnspecifiedRAILROAD MEDICARE
KY64956048Medicaid
OH0410577Medicare PIN