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General NPI Number Information
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NPI Number | 1144570870
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Entity Type | Organization
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Legal Business Name | KENNETH L. SCHAUFELBERGER, M.D., S.C.
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 2105 E ENTERPRISE AVE
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City | APPLETON
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State | WI
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Zip | 54913-7862
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Country | US
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Telephone | 920-731-3311
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Fax | 920-731-7133
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Provider Business Mailing Address
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Address Line | 2105 E ENTERPRISE AVE
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City | APPLETON
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State | WI
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Zip | 54913-7862
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Country | US
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Telephone | 920-731-3311
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Fax | 920-731-7133
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH L. SCHAUFELBERGER
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Credential | M.D.
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Telephone | 920-731-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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