MEDICARE: DR. FREDERICK THEODORE CHAYKOWSKI 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	207XS0106X	Orthopaedic Hand Surgery Physician	01040342A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	200015790	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00000089405	OTHER		ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306849468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK THEODORE CHAYKOWSKI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2526
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46801-2526
Country	:	US
Telephone Number	:	260-436-8686
Fax Number	:	260-436-8585

Provider Business Practice Location Address
First Line	:	323 GOLFWAY DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46814-9159
Country	:	US
Telephone Number	:	260-436-8686
Fax Number	:	260-436-8585

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	12/15/2020

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Directions to “ DR. FREDERICK THEODORE CHAYKOWSKI M.D.” Practice Location

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