MEDICARE: DR. THOMAS SCHLATER

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	152W00000X	Optometrist	4876	OH
2	152W00000X	Optometrist	0601800257	VA
3	152W00000X	Optometrist	0618001115	VA

General Provider Information

NPI Number	:	1073513099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS SCHLATER

Provider Business Mailing Address
First Line	:	2365 NORTH WOLFSNARE DRIVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1035 NIDER BLVD
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23521
Country	:	US
Telephone Number	:	757-314-7413
Fax Number	:

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

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	07/08/2007

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