Healthcare Provider Details

I. General information

NPI: 1639171838
Provider Name (Legal Business Name): MICHAEL A SCHIANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COURTNEY DR
CHARLESTON WV
25304-2696
US

IV. Provider business mailing address

1 COURTNEY DR
CHARLESTON WV
25304-2696
US

V. Phone/Fax

Practice location:
  • Phone: 304-925-4200
  • Fax: 304-925-0483
Mailing address:
  • Phone: 304-925-4200
  • Fax: 304-925-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number18239
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: