Provider Demographics
NPI:1194727230
Name:SCHOWENGERDT, DANIEL (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:SCHOWENGERDT
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 1:301 S WASHINGTON ST
Mailing Address - Street 2:PO BOX 778
Mailing Address - City:COLDWATER
Mailing Address - State:KS
Mailing Address - Zip Code:67029-9758
Mailing Address - Country:US
Mailing Address - Phone:620-582-2136
Mailing Address - Fax:620-582-2572
Practice Address - Street 1:301 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:KS
Practice Address - Zip Code:67029-9758
Practice Address - Country:US
Practice Address - Phone:620-582-2136
Practice Address - Fax:620-582-2572
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0423426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100133610BMedicaid
KSE55950Medicare UPIN
KS100889Medicare ID - Type Unspecified