Basic Information
Provider Information
NPI: 1821068826
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHWEND
FirstName: PHILLIP
MiddleName: P.
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 GRANT BLVD W
Address2:  
City: WABASHA
State: MN
PostalCode: 559811042
CountryCode: US
TelephoneNumber: 6515655600
FaxNumber:  
Practice Location
Address1: 1200 GRANT BLVD W
Address2:  
City: WABASHA
State: MN
PostalCode: 559811042
CountryCode: US
TelephoneNumber: 6515655600
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/24/2006
LastUpdateDate: 02/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X41335MNN Allopathic & Osteopathic PhysiciansFamily Medicine 
208600000X41335MNY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


Home