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General NPI Number Information
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NPI Number | 1215029145
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Entity Type | Individual
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Provider Name | WENDELIN WALTER SCHAEFER M. D.
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Gender | Male
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 978 FAIRWAY VIEW COURT
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City | INCLINE VILLAGE
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State | NV
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Zip | 89451
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Country | US
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Telephone | 775-833-2145
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Fax |
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Provider Business Mailing Address
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Address Line | 978 FAIRWAY VIEW COURT
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City | INCLINE VILLAGE
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State | NV
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Zip | 89451
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Country | US
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Telephone | 775-833-2145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 18918-020
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G14516
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License Number State | CA
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