MEDICARE: GARY A. MILKOVICH, D.O., INC.

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	207K00000X	Allergy & Immunology Physician

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
2	1457392292	OTHER	OH	INDIVIDUAL NPI

General Provider Information

NPI Number	:	1932382926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARY A. MILKOVICH, D.O., INC.

Provider Business Mailing Address
First Line	:	6044 BROADVIEW RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44134-3106
Country	:	US
Telephone Number	:	216-563-1003
Fax Number	:	216-563-1016

Provider Business Practice Location Address
First Line	:	6044 BROADVIEW RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44134-3106
Country	:	US
Telephone Number	:	216-563-1003
Fax Number	:	216-563-1016

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GARY ALLAN MILKOVICH
Credential	:	D.O.
Telephone Number	:	216-563-1003

Provider Enumeration Date	:	12/12/2007
Last Update Date	:	03/04/2025

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