Provider Demographics
NPI:1073052239
Name:SCHAUWECKER, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SCHAUWECKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 PACIFIC ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-1517
Mailing Address - Country:US
Mailing Address - Phone:480-266-0491
Mailing Address - Fax:
Practice Address - Street 1:516 STRAND ST
Practice Address - Street 2:
Practice Address - City:FREDERIKSTED
Practice Address - State:VI
Practice Address - Zip Code:00840-3533
Practice Address - Country:US
Practice Address - Phone:340-718-0402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program