Provider Demographics
NPI:1043305451
Name:SCHOLIN, MICHAEL ALAN (AUD, CNIM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALAN
Last Name:SCHOLIN
Suffix:
Gender:M
Credentials:AUD, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WATERFORD CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1588
Mailing Address - Country:US
Mailing Address - Phone:608-469-2518
Mailing Address - Fax:608-273-1762
Practice Address - Street 1:27 WATERFORD CIR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1588
Practice Address - Country:US
Practice Address - Phone:608-237-1731
Practice Address - Fax:608-273-1762
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY57 002154231H00000X
PAAT006010231H00000X
IDAUD-1523231H00000X
WYA-978231H00000X
WI502-156231H00000X
TX80058231H00000X
MO2007005975231H00000X
NJ41YA00072100231H00000X
IL147001230231H00000X
VA2201001343231H00000X
COAUD-474231H00000X
UT6790352-4101231H00000X
IA000690231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIWI1264001Medicare Oscar/Certification