Healthcare Provider Details

I. General information

NPI: 1992784607
Provider Name (Legal Business Name): DONALD F SCHAUST
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 EXCELSIOR BLVD METHODIST HOSPITAL
ST LOUIS PARK MN
55426-4702
US

IV. Provider business mailing address

6465 WAYZATA BLVD STE 315
ST LOUIS PARK MN
55426-1728
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-5222
  • Fax: 952-993-6499
Mailing address:
  • Phone: 952-993-7169
  • Fax: 952-993-0300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR 060640-4
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: