Provider Demographics
NPI:1619061009
Name:SCHAUER, JANE ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:JANE ELLEN
Middle Name:
Last Name:SCHAUER
Suffix:
Gender:F
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:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-5356
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:201 CEDAR ST SE STE 7600
Practice Address - Street 2:PRESBYTERIAN HEART GROUP (PHG)
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4921
Practice Address - Country:US
Practice Address - Phone:505-563-2500
Practice Address - Fax:505-563-2599
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM99300207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000Z8572Medicaid
NMNM301132Medicare PIN
NM000Z8572Medicaid
NM$$$$$$$$$MMedicare PIN
NMNM301133Medicare PIN
NM$$$$$$$$$PMedicare PIN
$$$$$$$$$Medicare PIN