Provider Demographics
NPI:1841211109
Name:SCHNELLE, JOACHIM ERNST (MD)
Entity Type:Individual
Prefix:MR
First Name:JOACHIM
Middle Name:ERNST
Last Name:SCHNELLE
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 1:1515 S CLIFTON
Mailing Address - Street 2:STE 300
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2953
Mailing Address - Country:US
Mailing Address - Phone:316-682-6551
Mailing Address - Fax:316-682-8151
Practice Address - Street 1:1515 S CLIFTON
Practice Address - Street 2:STE 300
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2953
Practice Address - Country:US
Practice Address - Phone:316-682-6551
Practice Address - Fax:316-682-8151
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0415376207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B69026Medicare UPIN
KS003631Medicare ID - Type Unspecified