MEDICARE: THOMAS G. SCHLEICHER

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	305R00000X	Preferred Provider Organization	7129	VA

General Provider Information

NPI Number	:	1366647299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS G. SCHLEICHER

Provider Business Mailing Address
First Line	:	3630 BOULEVARD
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1342
Country	:	US
Telephone Number	:	804-526-0231
Fax Number	:	804-520-4332

Provider Business Practice Location Address
First Line	:	3630 BOULEVARD
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1342
Country	:	US
Telephone Number	:	804-526-0231
Fax Number	:	804-520-4332

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS G SCHLEICHER
Credential	:	DDS
Telephone Number	:	804-526-0231

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	07/30/2007

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