Basic Information
| Provider Information | |||||||||
| NPI: | 1619955242 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHANLABER | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | KEMP | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8 CLOVER LANE | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | WHITEFIELD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037885288 | ||||||||
| FaxNumber: | 6037885027 | ||||||||
| Practice Location | |||||||||
| Address1: | 8 CLOVER LANE | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | WHITEFIELD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03598 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037885288 | ||||||||
| FaxNumber: | 6037885027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 300 | NH | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | 30362407 | 05 | NH | MEDICAID | 1008771 | 05 | VT | MEDICAID |