MEDICARE: MICHAEL D. SCHALL, OD, PA

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	152W00000X	Optometrist	524	SC

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

General Provider Information

NPI Number	:	1477724904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL D. SCHALL, OD, PA

Provider Business Mailing Address
First Line	:	1415 REMOUNT RD
Second Line	:
City	:	N CHARLESTON
State	:	SC
Zip	:	29406-3326
Country	:	US
Telephone Number	:	843-554-7554
Fax Number	:	843-554-7550

Provider Business Practice Location Address
First Line	:	1415 REMOUNT RD
Second Line	:
City	:	N CHARLESTON
State	:	SC
Zip	:	29406-3326
Country	:	US
Telephone Number	:	843-554-7554
Fax Number	:	843-554-7550

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL D SCHALL
Credential	:	OD
Telephone Number	:	843-554-7554

Provider Enumeration Date	:	03/12/2008
Last Update Date	:	03/12/2008

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