Healthcare Provider Details
I. General information
NPI: 1447204466
Provider Name (Legal Business Name): WOLFRAM G SCHYNOLL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 05/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
900 W CLAIREMONT AVE
EAU CLAIRE WI
54701
US
IV. Provider business mailing address
2715 WEST FRANK ST
EAU CLAIRE WI
54703
US
V. Phone/Fax
- Phone: 715-839-4121
- Fax:
- Phone: 715-832-1508
- Fax: 715-834-5870
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 31080 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PE0004X |
| Taxonomy | Emergency Medical Services (Emergency Medicine) Physician |
| License Number | 31080 |
| License Number State | WI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207PP0204X |
| Taxonomy | Pediatric Emergency Medicine (Emergency Medicine) Physician |
| License Number | 31080 |
| License Number State | WI |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PT0002X |
| Taxonomy | Medical Toxicology (Emergency Medicine) Physician |
| License Number | 31080 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: