Provider Demographics
NPI:1255332797
Name:SCHEIDEMANN, WAYNE H (MD)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:H
Last Name:SCHEIDEMANN
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 1:755 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95453-3705
Mailing Address - Country:US
Mailing Address - Phone:707-263-3602
Mailing Address - Fax:707-263-3619
Practice Address - Street 1:755 11TH ST
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-3705
Practice Address - Country:US
Practice Address - Phone:707-263-3602
Practice Address - Fax:707-263-3619
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG61678207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery