Healthcare Provider Details

I. General information

NPI: 1396752069
Provider Name (Legal Business Name): RICHARD SCHOEWE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2381 RICE STREET
ROSEVILLE MN
55113
US

IV. Provider business mailing address

2381 RICE STREET
ROSEVILLE MN
55113
US

V. Phone/Fax

Practice location:
  • Phone: 651-482-9722
  • Fax: 651-482-9091
Mailing address:
  • Phone: 651-482-9722
  • Fax: 651-482-9091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19752
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: