MEDICARE: CHRISTIAN GERALD SCHROCK MD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	21961	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467546549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN GERALD SCHROCK MD

Provider Business Mailing Address
First Line	:	5700 BOTTINEAU BLVD
Second Line	:	SUITE 270
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55429-3183
Country	:	US
Telephone Number	:	763-520-4320
Fax Number	:	763-520-7055

Provider Business Practice Location Address
First Line	:	5700 BOTTINEAU BLVD
Second Line	:	SUITE 270
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55429-3183
Country	:	US
Telephone Number	:	763-520-4320
Fax Number	:	763-520-7055

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	05/09/2016

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