Basic Information
Provider Information
NPI: 1124052493
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHWEMM
FirstName: MICHAEL
MiddleName: STEVEN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5435 FELTL RD
Address2: C/O EPPA
City: MINNETONKA
State: MN
PostalCode: 553437983
CountryCode: US
TelephoneNumber: 9528359880
FaxNumber:  
Practice Location
Address1: 5435 FELTL RD
Address2: C/O EPPA
City: MINNETONKA
State: MN
PostalCode: 553437983
CountryCode: US
TelephoneNumber: 9528359880
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/10/2006
LastUpdateDate: 03/18/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X36403IAN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X017622MEN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X51790MNY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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