| Clara Jackson Schermerhorn, Md, Phd, Llc | |
|
2539 Hayes Ave Fremont OH 43420-2638 | |
| (419) 334-9716 | |
| (419) 355-8171 |
| Full Name | Clara Jackson Schermerhorn, Md, Phd, Llc |
|---|---|
| Speciality | Pediatrics |
| Location | 2539 Hayes Ave, Fremont, Ohio |
| Authorized Official Name and Position | Clara Marie Schermerhorn (PHYSICIAN) |
| Authorized Official Contact | 4193349716 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clara Jackson Schermerhorn, Md, Phd, Llc 2539 Hayes Ave Fremont OH 43420-2638 Ph: (419) 334-9716 | Clara Jackson Schermerhorn, Md, Phd, Llc 2539 Hayes Ave Fremont OH 43420-2638 Ph: (419) 334-9716 |
| NPI Number | 1790793917 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5395010953 |
|---|---|
| Medicare Enrollment ID | O20171006001786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790793917 | NPI | - | NPPES |
| 35-088014 | Other | OH | OHIO LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35-088014 (Ohio) | Primary |
| 208000000X | Pediatrics | 35-088014 (Ohio) | Primary |
| Provider Name | Clara Schermerhorn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497773998 PECOS PAC ID: 3274536859 Enrollment ID: I20060822000000 |
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