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General NPI Number Information
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NPI Number | 1548486590
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Entity Type | Organization
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Legal Business Name | SCHWIETERS MEDICAL PLLC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 2781 PILOT KNOB RD
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City | EAGAN
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State | MN
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Zip | 55121-1119
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Country | US
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Telephone | 651-289-7300
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Fax | 651-289-7301
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Provider Business Mailing Address
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Address Line | 2781 PILOT KNOB RD
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City | EAGAN
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State | MN
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Zip | 55121-1119
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Country | US
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Telephone | 651-289-7300
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Fax | 651-289-7301
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Authorized Official
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Title or Position | ASSISTANT
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Name | CAROL SCHWIETERS
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Credential |
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Telephone | 651-289-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 48212
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License Number State | MN
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