Provider Demographics
NPI:1568758712
Name:SCHWALBE, TAMARA N (OD)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:N
Last Name:SCHWALBE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:N
Other - Last Name:LEVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1950 OLD GALLOWS RD STE 520
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:315 W IRELAND RD STE 103
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-3849
Practice Address - Country:US
Practice Address - Phone:574-291-9200
Practice Address - Fax:574-291-9859
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003867A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist