Provider Demographics
NPI:1437102811
Name:SCHARKO, ALEXANDER M (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:M
Last Name:SCHARKO
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 1:1300 SOUTH DRIVE
Mailing Address - Street 2:PO BOX 9
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54985
Mailing Address - Country:US
Mailing Address - Phone:920-235-4910
Mailing Address - Fax:920-237-2053
Practice Address - Street 1:1300 SOUTH DRIVE
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:WI
Practice Address - Zip Code:54985
Practice Address - Country:US
Practice Address - Phone:920-235-4910
Practice Address - Fax:920-237-2053
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4446472084P0804X
WI381932084P0800X
MDD00580202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
000018557ROtherHUMANA
WI32489200Medicaid
G82371Medicare UPIN
WI32489200Medicaid