Individual
KIM M SCHAD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18101 LORAIN AVE, CLEVELAND, OH 44111-5612
(216) 476-7000
Mailing address
PO BOX 74953, CLEVELAND, OH 44194-1036
(440) 879-0081
(440) 879-0084
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50-000990
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000331804
ANTHEM
OH
01
—
P00205084
RAILROAD MEDICARE
OH
Enumeration date
12/23/2005
Last updated
07/08/2007
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