MEDICARE: EVGENIY A SHCHELCHKOV MD

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	2084N0400X	Neurology Physician	0101235474	VA
2	2084N0400X	Neurology Physician	MD421060	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	345616	OTHER	VA	ANTHEM
2	7730501	OTHER	VA	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	10028259	OTHER	VA	OPTIMA/SENTARA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5927775	OTHER	VA	CIGNA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649276668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVGENIY A SHCHELCHKOV MD

Provider Business Mailing Address
First Line	:	225 OVERLOOK DR
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-2657
Country	:	US
Telephone Number	:	724-941-6057
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 OVERLOOK DR
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-2657
Country	:	US
Telephone Number	:	724-941-6057
Fax Number	:

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	10/18/2022

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