MEDICARE: JOSEFINA TANSECO SCHLOBOHM MD

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	2084P0800X	Psychiatry Physician	0101035134	VA
2	2084P0804X	Child & Adolescent Psychiatry Physician	0101035134	VA

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

General Provider Information

NPI Number	:	1669414389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEFINA TANSECO SCHLOBOHM MD

Provider Business Mailing Address
First Line	:	856 J CLYDE MORRIS BLVD
Second Line	:	SUITE A
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23601-1318
Country	:	US
Telephone Number	:	757-594-4006
Fax Number	:	757-534-5190

Provider Business Practice Location Address
First Line	:	2244 EXECUTIVE DR
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-2430
Country	:	US
Telephone Number	:	757-827-1001
Fax Number	:	757-827-3128

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

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	05/17/2011

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