Provider Demographics
NPI:1477601672
Name:DR. MICHAEL D. SCHLOSS, INC.
Entity Type:Organization
Organization Name:DR. MICHAEL D. SCHLOSS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHLOSS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:216-291-1255
Mailing Address - Street 1:14433 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3309
Mailing Address - Country:US
Mailing Address - Phone:216-291-1255
Mailing Address - Fax:216-291-6877
Practice Address - Street 1:14433 CEDAR RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-3309
Practice Address - Country:US
Practice Address - Phone:216-291-1255
Practice Address - Fax:216-291-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-07
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3145-T638152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0345371Medicaid
OH9393141Medicare PIN
OHT46901Medicare UPIN