Provider Demographics
NPI:1306392394
Name:ST. GIANNA FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:ST. GIANNA FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHEVE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:316-768-6444
Mailing Address - Street 1:2135 N RIDGE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-1406
Mailing Address - Country:US
Mailing Address - Phone:316-768-6444
Mailing Address - Fax:316-719-2406
Practice Address - Street 1:2135 N RIDGE RD STE 400
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-1404
Practice Address - Country:US
Practice Address - Phone:316-768-6444
Practice Address - Fax:316-719-2406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-36001207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA4027Medicare PIN