Provider Demographics
NPI:1710021308
Name:KALKSTEIN, THOMAS M (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:KALKSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GARDEN CITY DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1732
Mailing Address - Country:US
Mailing Address - Phone:412-373-9200
Mailing Address - Fax:412-373-7886
Practice Address - Street 1:200 GARDEN CITY DR
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1732
Practice Address - Country:US
Practice Address - Phone:412-373-9200
Practice Address - Fax:412-373-7886
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002787L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0989900Medicaid
PA453299OtherBCBS PROVIDER NUMBER
PA453299OtherBCBS PROVIDER NUMBER
PA453299Medicare ID - Type Unspecified