Provider Demographics
NPI:1164459558
Name:SCHEINBERG, KENNETH A (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:A
Last Name:SCHEINBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 48544
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-8544
Mailing Address - Country:US
Mailing Address - Phone:316-239-8383
Mailing Address - Fax:
Practice Address - Street 1:3450 N ROCK RD
Practice Address - Street 2:BLDG. 200 SUITE#207
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1352
Practice Address - Country:US
Practice Address - Phone:316-239-8383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS23010207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS16922OtherCOVENTRY
KS12149400OtherMULTIPLAN
KS200150OtherHPK
KS1163OtherPHS
KS12149400OtherMULTIPLAN