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1922024223

NPI Code Detail

MEDICARE: DR. TYLER E REIMSCHISEL MD

MEDICARE: DR. TYLER E REIMSCHISEL 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	207SG0201X	Clinical Genetics (M.D.) Physician	2005017785	MO
2	208000000X	Pediatrics Physician	MD43657	TN
3	2080P0006X	Developmental - Behavioral Pediatrics Physician	MD43657	TN
4	2084N0402X	Neurology with Special Qualifications in Child Neurology Physician	MD43657	TN
5	207SG0202X	Clinical Biochemical Genetics Physician	35.138604	OH

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	:	1922024223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TYLER E REIMSCHISEL MD

Provider Business Mailing Address
First Line	:	10900 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1712
Country	:	US
Telephone Number	:	216-368-0610
Fax Number	:

Provider Business Practice Location Address
First Line	:	11100 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1716
Country	:	US
Telephone Number	:	216-844-3936
Fax Number	:

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/09/2022

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Directions to “ DR. TYLER E REIMSCHISEL MD” Practice Location

Language	Start Address	Practice Location

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