MEDICARE: DR. CHARLES MATTHEW GILCHER D.C.

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	111N00000X	Chiropractor	2301006168	MI

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	950H234910	OTHER	MI	BCBSM
3	U51766	OTHER	MI	HAP
4	383277909	OTHER	MI	COMMERCIAL
5	950H253200	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1992793905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES MATTHEW GILCHER D.C.

Provider Business Mailing Address
First Line	:	3030 FORT ST
Second Line	:
City	:	LINCOLN PARK
State	:	MI
Zip	:	48146-2428
Country	:	US
Telephone Number	:	313-928-2777
Fax Number	:	313-928-2825

Provider Business Practice Location Address
First Line	:	3030 FORT ST
Second Line	:
City	:	LINCOLN PARK
State	:	MI
Zip	:	48146-2428
Country	:	US
Telephone Number	:	313-928-2777
Fax Number	:	313-928-2825

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	12/09/2011

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