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NPI Code Detail

MEDICARE: MICHELLE ANN MEDLIK

MEDICARE: MICHELLE ANN MEDLIK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist0001914OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023622008
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE ANN MEDLIK
Provider Business Mailing Address
First Line : 3615 SPOKANE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-3827
Country : US
Telephone Number : 216-534-0433
Fax Number :
Provider Business Practice Location Address
First Line : 13377 SMITH RD
Second Line :
City : MIDDLEBURG HEIGHTS
State : OH
Zip : 44130-7810
Country : US
Telephone Number : 440-340-5558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2020
Last Update Date : 09/07/2020

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Directions to “ MICHELLE ANN MEDLIK ” Practice Location

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