MEDICARE: CHRISTOPHER SCHWIMER D.O.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	5101015559	MI
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	34007667	OH
3	207ZD0900X	Dermatopathology (Pathology) Physician	5101015559	MI
4	207ZD0900X	Dermatopathology (Pathology) Physician	34007667	OH

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0H70792	OTHER	MI	BLUE CROSS BLUE SHEILD

NPI Number	:	1417918509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER SCHWIMER D.O.

Provider Business Mailing Address
First Line	:	30200 TELEGRAPH RD
Second Line	:	SUITE 405
City	:	BINGHAM FARMS
State	:	MI
Zip	:	48025-4502
Country	:	US
Telephone Number	:	248-220-4425
Fax Number	:	248-220-4428

Provider Business Practice Location Address
First Line	:	30200 TELEGRAPH RD
Second Line	:	SUITE 405
City	:	BINGHAM FARMS
State	:	MI
Zip	:	48025-4502
Country	:	US
Telephone Number	:	248-220-4425
Fax Number	:	248-220-4428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	11/13/2013

30200 TELEGRAPH RD , STE 179
BINGHAM FARMS, MI
48025-4502

Practice Phone: 248-258-1919
Practice Fax: 248-258-9624

30200 TELEGRAPH RD , SUITE 220
BINGHAM FARMS, MI
48025-4502