Provider Demographics
NPI:1942215835
Name:SCIOLARO, CHARLES MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MICHAEL
Last Name:SCIOLARO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3109 W 118TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-3059
Mailing Address - Country:US
Mailing Address - Phone:913-660-0438
Mailing Address - Fax:913-676-6059
Practice Address - Street 1:8919 PARALLEL PKWY
Practice Address - Street 2:SUITE 203
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1636
Practice Address - Country:US
Practice Address - Phone:913-660-0438
Practice Address - Fax:913-676-6059
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2019-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-26585208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100255720BMedicaid
KSP899417AMedicare ID - Type UnspecifiedMEDICARE