MEDICARE: DR. GEORGE WALKER SCHMEDLEN PH.D., J.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	103TF0200X	Forensic Psychologist	3205	OH

General Provider Information

NPI Number	:	1902005556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE WALKER SCHMEDLEN PH.D., J.D.

Provider Business Mailing Address
First Line	:	17415 WINSLOW RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-3425
Country	:	US
Telephone Number	:	216-443-7339
Fax Number	:	216-443-7332

Provider Business Practice Location Address
First Line	:	17415 WINSLOW RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44120-3425
Country	:	US
Telephone Number	:	216-443-7339
Fax Number	:	216-443-7332

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

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	07/13/2007

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