Basic Information
Provider Information
NPI: 1396838389
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHMOLL
FirstName: DANIEL
MiddleName: W
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 931288
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641930001
CountryCode: US
TelephoneNumber: 9137894155
FaxNumber:  
Practice Location
Address1: 7301 E FRONTAGE RD
Address2: SUITE 100
City: SHAWNEE MISSION
State: KS
PostalCode: 662041654
CountryCode: US
TelephoneNumber: 9133844040
FaxNumber: 9133844093
Other Information
ProviderEnumerationDate: 10/02/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X04-25266KSY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
2101102101KSBLUE CROSSOTHER


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