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General NPI Number Information
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NPI Number | 1578625794
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Entity Type | Organization
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Legal Business Name | MICHAEL A SCHELLPFEFFER MD OB GYN SC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1400 75TH STREET
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City | KENOSHA
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State | WI
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Zip | 53143
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Country | US
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Telephone | 262-658-2133
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Fax | 262-658-2699
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Provider Business Mailing Address
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Address Line | 1400 75TH ST SUITE #1
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City | KENOSHA
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State | WI
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Zip | 53143
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Country | US
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Telephone | 262-658-2133
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Fax | 262-658-2699
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | MICHAEL A SCHELLPFEFFER
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Credential | MD
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Telephone | 262-658-2133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25699020
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License Number State | WI
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