Basic Information
Provider Information
NPI: 1356862056
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHOENBRUNNER
FirstName: ANNA
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 915 OLENTANGY RIVER RD STE 2140
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432123153
CountryCode: US
TelephoneNumber: 6142938566
FaxNumber: 6142939024
Practice Location
Address1: 410 W 10TH AVE
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432101240
CountryCode: US
TelephoneNumber: 6142938000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/03/2017
LastUpdateDate: 07/03/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0122X57.029312OHY Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery

No ID Information.


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