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NPI Code Detail

MEDICARE: DR. LOUIS MICHAEL SCHLICKMAN M.D.

MEDICARE: DR. LOUIS MICHAEL SCHLICKMAN 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
1207R00000XInternal Medicine PhysicianM7522ID

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00191484OTHERIDRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3201188708OTHERIDCHAMPUS

General Provider Information

NPI Number : 1629022116
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUIS MICHAEL SCHLICKMAN M.D.
Provider Business Mailing Address
First Line : 3080 E GENTRY WAY
Second Line : SUITE 200
City : MERIDIAN
State : ID
Zip : 83642-3013
Country : US
Telephone Number : 208-884-3770
Fax Number : 541-278-8360
Provider Business Practice Location Address
First Line : 3080 E GENTRY WAY
Second Line : SUITE 200
City : MERIDIAN
State : ID
Zip : 83642-3013
Country : US
Telephone Number : 208-884-3770
Fax Number : 541-278-8360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 08/10/2011

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