Provider Demographics
NPI:1023159712
Name:SCHEIDT, KARL BURTON (MD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:BURTON
Last Name:SCHEIDT
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 1:7325 FOLEY RD
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-9761
Mailing Address - Country:US
Mailing Address - Phone:262-818-4683
Mailing Address - Fax:
Practice Address - Street 1:7325 FOLEY RD
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53402-9761
Practice Address - Country:US
Practice Address - Phone:262-818-4683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2016-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI29510207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31819500Medicaid
WIF09433Medicare UPIN
WI0589760001Medicare NSC
WI000032275Medicare PIN