Provider Demographics
NPI:1891735650
Name:SCHOEN-KIEWERT, ERICH S (MD)
Entity Type:Individual
Prefix:DR
First Name:ERICH
Middle Name:S
Last Name:SCHOEN-KIEWERT
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 1:4854 PINOT ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5162
Mailing Address - Country:US
Mailing Address - Phone:214-244-6488
Mailing Address - Fax:321-244-6488
Practice Address - Street 1:4854 PINOT ST
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5162
Practice Address - Country:US
Practice Address - Phone:321-241-6800
Practice Address - Fax:321-241-6888
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8368207P00000X, 207Q00000X
FLME132651207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023536500Medicaid
TX8V1360OtherBLUE SHIELD NUMBER