MEDICARE: DR. MARK E. CHARIKER M.D.

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	2082S0099X	Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician	29607	KY
2	2082S0105X	Surgery of the Hand (Plastic Surgery) Physician	29607	KY
3	2086S0122X	Plastic and Reconstructive Surgery Physician	29607	KY

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	000000206969	OTHER	KY	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194724997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK E. CHARIKER M.D.

Provider Business Mailing Address
First Line	:	222 S 1ST ST
Second Line	:	SUITE 100
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1350
Country	:	US
Telephone Number	:	502-568-4800
Fax Number	:	502-589-6882

Provider Business Practice Location Address
First Line	:	222 S 1ST ST
Second Line	:	SUITE 100
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1350
Country	:	US
Telephone Number	:	502-568-4800
Fax Number	:	502-589-6882

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	10/03/2014

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Directions to “ DR. MARK E. CHARIKER M.D.” Practice Location

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