Provider Demographics
NPI:1215060140
Name:SCHMULEVICH, RAFAEL L (MD)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:L
Last Name:SCHMULEVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 SUMMIT AVE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7597
Mailing Address - Fax:740-283-7190
Practice Address - Street 1:4100 JOHNSON RD STE 207
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2372
Practice Address - Country:US
Practice Address - Phone:740-266-9169
Practice Address - Fax:740-266-6933
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040586E207RC0000X
WV14695207RC0000X
OH35062485S207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0071448000Medicaid
OH060044120OtherRAILROAD MEDICARE
OHPO1095907OtherRR MEDICARE
OH0848319Medicaid
WV0702357Medicare PIN
OHF13281Medicare UPIN
OH0702356Medicare PIN
OH0848319Medicaid
WV0071448000Medicaid