Provider Demographics
NPI:1639171838
Name:SCHIANO, MICHAEL A (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:SCHIANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-2696
Mailing Address - Country:US
Mailing Address - Phone:304-925-4200
Mailing Address - Fax:304-925-0483
Practice Address - Street 1:1 COURTNEY DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2696
Practice Address - Country:US
Practice Address - Phone:304-925-4200
Practice Address - Fax:304-925-0483
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18239207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV18239OtherWV STATE LICENSE
WV0078182000Medicaid
9342791Medicare ID - Type Unspecified
WV0078182000Medicaid