Provider Demographics
NPI:1164491833
Name:SCHWERKOSKE, JOHN F (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:SCHWERKOSKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 LAKE RD
Mailing Address - Street 2:STE 110
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-1709
Mailing Address - Country:US
Mailing Address - Phone:651-735-7414
Mailing Address - Fax:651-735-1827
Practice Address - Street 1:6025 LAKE RD
Practice Address - Street 2:STE 110
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1709
Practice Address - Country:US
Practice Address - Phone:651-735-7414
Practice Address - Fax:651-735-1827
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN34675207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN105479OtherUCARE MN
MN8R423SCOtherBLUE CROSS BLUE SHIELD MN
MNHP14356OtherHEALTHPARTNERS
MN23261OtherAMERICA'S PPO
WI32097400Medicaid
MN3600785OtherMEDICA
MN0010105OtherPREFERRED ONE
MN997568300Medicaid
MNA97202Medicare UPIN
MN8R423SCOtherBLUE CROSS BLUE SHIELD MN
MNHP14356OtherHEALTHPARTNERS