Provider Demographics
NPI:1427119866
Name:SCHOFIELD, MINKA LATRICE (MD)
Entity type:Individual
Prefix:DR
First Name:MINKA
Middle Name:LATRICE
Last Name:SCHOFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-2594
Mailing Address - Fax:614-293-4487
Practice Address - Street 1:5175 MORSE RD
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1370
Practice Address - Country:US
Practice Address - Phone:614-293-9730
Practice Address - Fax:614-293-7027
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083135207Y00000X
MDD64856207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2847781Medicaid
OHSC4141422Medicare PIN
OH2847781Medicaid