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General NPI Number Information
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NPI Number | 1629456546
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Entity Type | Individual
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Provider Name | CHAD MITCHELL SCHWALB D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2015
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Last Update Date | 07/25/2018
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Provider Practice Location Address
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Address Line | 21647 RYAN RD
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City | WARREN
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State | MI
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Zip | 48091
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Country | US
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Telephone | 586-754-7777
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Fax | 586-754-7781
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Provider Business Mailing Address
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Address Line | 3095 SHADYDALE LN
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323-1853
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Country | US
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Telephone | 248-408-6540
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 5901002594
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License Number State | MI
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