Provider Demographics
NPI:1831517028
Name:SCHWERDTFAGER, JULIANNE (MD)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:SCHWERDTFAGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S. SANTA FE AVE, SUITE 100
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401
Mailing Address - Country:US
Mailing Address - Phone:785-825-2273
Mailing Address - Fax:785-825-2275
Practice Address - Street 1:501 S SANTA FE AVE STE 100
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401
Practice Address - Country:US
Practice Address - Phone:785-825-2273
Practice Address - Fax:785-825-2275
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0440255208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201165830AMedicaid