Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 3145T638 | OH |
NPI | 1013190867 |
---|---|
Provider Name | Michael D Schloss |
First Address | Cleveland, OH 44121-3309 |
Second Address | Cleveland, OH 44121-3309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2007 |
Last Update Date | 18/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0345371 | (05) | OH |
T46901 | (02) | OH |