1487741625 NPI number — KENNETH S SCHER MD

Table of content: (NPI 1487741625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487741625 NPI number — KENNETH S SCHER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KENNETH S SCHER MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487741625
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4555 W SCHROEDER DR
Provider Second Line Business Mailing Address:
#170
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53223-1475
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-365-3210
Provider Business Mailing Address Fax Number:
414-365-3225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3267 S 16TH ST
Provider Second Line Business Practice Location Address:
#207
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53215-4500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-647-2899
Provider Business Practice Location Address Fax Number:
414-647-1800
Provider Enumeration Date:
10/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCHER
Authorized Official First Name:
KENNETH
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
414-647-5069

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 31583200 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




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