MEDICARE: MARK A SCHOMOGYI M.D.

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
1	207R00000X	Internal Medicine Physician	MD00032064	WA
2	207RI0200X	Infectious Disease Physician	100163-875	WI
3	207RI0200X	Infectious Disease Physician	102896	MT
4	207RI0200X	Infectious Disease Physician	MD00032064	WA

Other Identifiers

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

General Provider Information

NPI Number	:	1407848559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK A SCHOMOGYI M.D.

Provider Business Mailing Address
First Line	:	1802 YAKIMA AVE STE 104
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-5303
Country	:	US
Telephone Number	:	253-426-6739
Fax Number	:

Provider Business Practice Location Address
First Line	:	1802 YAKIMA AVE STE 104
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-5303
Country	:	US
Telephone Number	:	253-426-6739
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	03/30/2023

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Directions to “ MARK A SCHOMOGYI M.D.” Practice Location

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