MEDICARE: TAMMI LOUISE SHLOTZHAUER 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	207RR0500X	Rheumatology Physician	167996	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P010167996	OTHER	NY	EXCELLUS PROVIDER NO
2	167996	OTHER	NY	NY STATE LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	101160CD	OTHER	NY	PREFERRED CARE NO
5	P010167996	OTHER	NY	BLUE CROSS/BLUE SHIELD NO

General Provider Information

NPI Number	:	1861457251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMI LOUISE SHLOTZHAUER M.D.

Provider Business Mailing Address
First Line	:	500 HELENDALE RD
Second Line	:	SUITE 90
City	:	ROCHESTER
State	:	NY
Zip	:	14609-3173
Country	:	US
Telephone Number	:	585-288-0530
Fax Number	:	585-288-3363

Provider Business Practice Location Address
First Line	:	500 HELENDALE RD
Second Line	:	SUITE 90
City	:	ROCHESTER
State	:	NY
Zip	:	14609-3173
Country	:	US
Telephone Number	:	585-288-0530
Fax Number	:	585-288-3363

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	11/12/2010

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Directions to “ TAMMI LOUISE SHLOTZHAUER M.D.” Practice Location

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