MEDICARE: DR. RONALD J KALCHIK DO

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	207Q00000X	Family Medicine Physician	34004852	OH

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

General Provider Information

NPI Number	:	1043200249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD J KALCHIK DO

Provider Business Mailing Address
First Line	:	PO BOX 1821
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43702-1821
Country	:	US
Telephone Number	:	740-455-3342
Fax Number	:	740-455-3686

Provider Business Practice Location Address
First Line	:	200 N MAYSVILLE AVE
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43701-6172
Country	:	US
Telephone Number	:	740-455-3112
Fax Number	:	740-455-1363

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

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	07/08/2007

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