Michael Joseph Scheidecker, RPH
Individual provider Active NPI Pharmacist · Wausau, WI
NPI 1336493089 · NPPES record last updated Nov 2, 2012
Key facts
- NPI
- 1336493089
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 12311-40 (WI)
- Practice address
- 110 S 17TH Ave
Wausau, WI 54401-4227 - Phone
- (715) 848-9066
- Fax
- (715) 845-9891
- NPI assigned
- Nov 2, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12311-40 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T a Solberg Co Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12311-40 | WI | Yes |
Addresses
Primary practice location
110 S 17TH Ave
Wausau, WI 54401-4227
Mailing address
110 S 17TH Ave
Wausau, WI 54401-4227
Phone (715) 848-9066
Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.