Provider Demographics
NPI:1821068826
Name:SCHWEND, PHILLIP P (DO)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:P
Last Name:SCHWEND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 GRANT BLVD W
Mailing Address - Street 2:
Mailing Address - City:WABASHA
Mailing Address - State:MN
Mailing Address - Zip Code:55981-1042
Mailing Address - Country:US
Mailing Address - Phone:651-565-5600
Mailing Address - Fax:
Practice Address - Street 1:1200 GRANT BLVD W
Practice Address - Street 2:
Practice Address - City:WABASHA
Practice Address - State:MN
Practice Address - Zip Code:55981-1042
Practice Address - Country:US
Practice Address - Phone:651-565-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN41335207Q00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN281518400Medicaid
MN020001257Medicare ID - Type Unspecified
MNF61991Medicare UPIN