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General NPI Number Information
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NPI Number | 1235128299
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Entity Type | Individual
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Provider Name | MICHAEL R SCHWARTZWALD R.PH.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 108 S 6TH ST
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City | BRAINERD
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State | MN
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Zip | 56401-3575
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Country | US
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Telephone | 218-829-0347
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Fax |
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Provider Business Mailing Address
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Address Line | 26235 RABBIT TRL
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City | AITKIN
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State | MN
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Zip | 56431-3172
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Country | US
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Telephone | 218-829-0347
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 115122-0
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License Number State | MN
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