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NPI Code Detail

MEDICARE: DR. GARY D CHAIKIN M.D.

MEDICARE: DR. GARY D CHAIKIN 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
12084P0800XPsychiatry Physician40442-020WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2130171OTHERUCARE
36K663CHOTHERMNBCBS-MN

General Provider Information

NPI Number : 1285859355
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GARY D CHAIKIN M.D.
Provider Business Mailing Address
First Line : 704 SAND LAKE RD
Second Line :
City : ONALASKA
State : WI
Zip : 54650-2400
Country : US
Telephone Number : 608-781-6463
Fax Number : 608-781-6467
Provider Business Practice Location Address
First Line : 343 WOODLAKE DR SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-6242
Country : US
Telephone Number : 507-289-2089
Fax Number : 507-535-5791
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 11/07/2018

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