MEDICARE: OREST STECYK MD

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	207P00000X	Emergency Medicine Physician	35046642S	OH
2	207Q00000X	Family Medicine Physician	35-046642	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063453611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OREST STECYK MD

Provider Business Mailing Address
First Line	:	PO BOX 931591
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-1719
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 E ROYALTON RD # 101
Second Line	:
City	:	BROADVIEW HTS
State	:	OH
Zip	:	44147-2591
Country	:	US
Telephone Number	:	440-743-4740
Fax Number	:

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	01/11/2021

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Directions to “ OREST STECYK MD” Practice Location

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