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Individual

DR. LOUIS MICHAEL SCHLICKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3080 E GENTRY WAY, SUITE 200, MERIDIAN, ID 83642-3013
(208) 884-3770
(541) 278-8360
Mailing address
3080 E GENTRY WAY, SUITE 200, MERIDIAN, ID 83642-3013
(208) 884-3770
(541) 278-8360

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M7522
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201188708
CHAMPUS
ID
05
805294800
ID
01
P00191484
RAILROAD MEDICARE
ID
Enumeration date
05/20/2006
Last updated
08/10/2011
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