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NPI Code Detail

MEDICARE: DR. THOMAS G CHULSKI MD

MEDICARE: DR. THOMAS G CHULSKI 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
1207Q00000XFamily Medicine Physician41922WI

Other Identifiers

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

General Provider Information

NPI Number : 1700870607
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS G CHULSKI MD
Provider Business Mailing Address
First Line : 900 E DIVISION ST
Second Line :
City : WAUTOMA
State : WI
Zip : 54982-6944
Country : US
Telephone Number : 920-787-6900
Fax Number : 920-787-6903
Provider Business Practice Location Address
First Line : 900 E DIVISION ST
Second Line :
City : WAUTOMA
State : WI
Zip : 54982-6944
Country : US
Telephone Number : 920-787-6900
Fax Number : 920-787-6903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 10/20/2011

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