Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 31080 | WI |
N | 207PE0004X | Emergency Medical Services | 31080 | WI |
N | 207PP0204X | Pediatric Emergency Physician | 31080 | WI |
NPI | 1447204466 |
---|---|
Provider Name | Mr. Wolfram G Schynoll |
First Address | Eau Claire, WI 54703 |
Second Address | Eau Claire, WI 54701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31583300 | (05) | WI |
F07082 | (02) |