Provider Demographics
NPI:1073547261
Name:CHMELICEK, THOMAS V (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:V
Last Name:CHMELICEK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1155 MILL ST # MCM14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5225
Practice Address - Street 1:975 RYLAND ST STE 100
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1669
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-5225
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2025-01-13
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Provider Licenses
StateLicense IDTaxonomies
NV26857207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00453643Medicare PIN
NYRB6120Medicare PIN