Individual
DR. KENNETH G SCHELLHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 NW BARSTOW ST, WAUKESHA FAMILY PRACTICE CENTER, WAUKESHA, WI 53188-3771
(262) 548-6907
(262) 548-3820
Mailing address
210 NW BARSTOW ST, WAUKESHA FAMILY PRACTICE CENTER, WAUKESHA, WI 53188-3771
(262) 548-6907
(262) 548-3820
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43093
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005006261T
HUMANA
—
05
—
1982655452
—
WI
Enumeration date
05/12/2006
Last updated
10/09/2013
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