Healthcare Provider Details

I. General information

NPI: 1174559256
Provider Name (Legal Business Name): PHILLIP M SCHIRCK, MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 CLARKSON HAMLIN TOWNLINE ROAD
HAMLIN NY
14464
US

IV. Provider business mailing address

790 LINDEN AVE
ROCHESTER NY
14625-2716
US

V. Phone/Fax

Practice location:
  • Phone: 585-964-8880
  • Fax: 585-964-8886
Mailing address:
  • Phone: 585-385-9030
  • Fax: 585-385-9124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number177181
License Number StateNY

VIII. Authorized Official

Name: PHILLIP MICHAEL SCHIRCK
Title or Position: OWNER
Credential: MD
Phone: 585-964-8880