Basic Information
| Provider Information | |||||||||
| NPI: | 1447281266 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASNIS | ||||||||
| FirstName: | MAXINE | ||||||||
| MiddleName: | SCHWARTZ | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SCHWARTZ | ||||||||
| OtherFirstName: | MAXINE | ||||||||
| OtherMiddleName: | ANNE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 40602 COUNTY ROAD 1 | ||||||||
| Address2: | |||||||||
| City: | RICE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563679594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 811 2ND ST SE STE A | ||||||||
| Address2: | |||||||||
| City: | LITTLE FALLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 563453505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3206326611 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 42803 | MN | X | Allopathic & Osteopathic Physicians | Pediatrics | 2080N0001X | 42803 | MN | X | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | A028 | 01 | MN | TRICARE | OTHER | NA9231025717 | 01 | PREFERRED ONE | OTHER | 1155282 | 01 | AMERICA'S PPO | OTHER | 1202469 | 01 | MEDICA | OTHER | HP31772 | 01 | HEALTH PARTNERS | OTHER | 083L6AS | 01 | MN | BCBS OF MN | OTHER |