Healthcare Provider Details

I. General information

NPI: 1881682805
Provider Name (Legal Business Name): AARON T. SCHWAAB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 10/27/2023
Certification Date: 10/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 RIDGE ST
STOUGHTON WI
53589-1864
US

IV. Provider business mailing address

6310 MOURNING DOVE DR
MC FARLAND WI
53558-9018
US

V. Phone/Fax

Practice location:
  • Phone: 608-873-6611
  • Fax: 608-873-2255
Mailing address:
  • Phone: 608-873-6611
  • Fax: 608-873-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036106456
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: