Provider Demographics
NPI:1689655748
Name:SCHWIETERS, KURT EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:EDWARD
Last Name:SCHWIETERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:525 MAIN ST W
Mailing Address - Street 2:CENTRACARE HEALTH SYSTEM - MELROSE
Mailing Address - City:MELROSE
Mailing Address - State:MN
Mailing Address - Zip Code:56352-1043
Mailing Address - Country:US
Mailing Address - Phone:320-256-4228
Mailing Address - Fax:320-256-7106
Practice Address - Street 1:525 MAIN ST W
Practice Address - Street 2:CENTRACARE HEALTH SYSTEM - MELROSE
Practice Address - City:MELROSE
Practice Address - State:MN
Practice Address - Zip Code:56352-1043
Practice Address - Country:US
Practice Address - Phone:320-256-4228
Practice Address - Fax:320-256-7106
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2023-03-07
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN41074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
091521100OtherMEDICAL ASSISTANCE
67D15SCOtherBLUE CROSS BLUE SHIELD
123455OtherUCARE
2114121OtherFIRST HEALTH PLAN
844843OtherARAZ GROUP AMERICAS PPO
1019737OtherPREFERRED ONE
HP28378OtherHEALTH PARTNERS
0110894OtherMEDICA HEALTH PLANS
BS5602354OtherDEA
123455OtherUCARE
67D15SCOtherBLUE CROSS BLUE SHIELD
G85466Medicare UPIN