Physician Compare National (NPI:1124061551)

HEALTHCARE PROVIDER: GEORGE SHAKER COHLMIA JR. M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1124061551
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709831431
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091202000256
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COHLMIA
	Individual professional last name
Provider First Name	GEORGE
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KANSAS MEDICAL COLLEGE
	Individual professional's medical school
Graduation Year	1975
	Individual professional's medical school graduation year
Primary Specialty	CARDIAC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1373 E BOONE ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 3400
	Group Practice or individual's line 2 address
City	TAHLEQUAH
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	744643330
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	370089
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHEASTERN HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370171
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHEROKEE NATION W W HASTINGS INDIAN HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y