Basic Information
| Provider Information | |||||||||
| NPI: | 1316946791 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHWEITZER | ||||||||
| FirstName: | EDMUND | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10547 MONTGOMERY RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452424418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137916611 | ||||||||
| FaxNumber: | 5137916788 | ||||||||
| Practice Location | |||||||||
| Address1: | 10547 MONTGOMERY RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452424418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137916611 | ||||||||
| FaxNumber: | 5137916788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2005 | ||||||||
| LastUpdateDate: | 12/31/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 35-03-5089 | OH | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0353237 | 05 | OH | MEDICAID |