MEDICARE: THOMAS V SCHALCOSKY DO

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	207Q00000X	Family Medicine Physician	0102049850	VA
2	207Q00000X	Family Medicine Physician	34010077	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080188665	OTHER		MEDICARE RAILROAD PROVIDER NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	434853	OTHER	ANTHEM
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598749814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS V SCHALCOSKY DO

Provider Business Mailing Address
First Line	:	4180 WARRENSVILLE CENTER RD BLDG 5
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44122-7024
Country	:	US
Telephone Number	:	216-491-7888
Fax Number	:	216-491-7887

Provider Business Practice Location Address
First Line	:	4180 WARRENSVILLE CENTER RD
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44122-7024
Country	:	US
Telephone Number	:	216-491-7888
Fax Number	:	216-491-7887

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	02/17/2017

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Directions to “ THOMAS V SCHALCOSKY DO” Practice Location

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