Provider Demographics
NPI:1023096567
Name:SCHWENDINGER, ANGELA M (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:SCHWENDINGER
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 1:740 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IA
Mailing Address - Zip Code:52310-1745
Mailing Address - Country:US
Mailing Address - Phone:319-465-6702
Mailing Address - Fax:319-465-6727
Practice Address - Street 1:740 E OAK ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IA
Practice Address - Zip Code:52310-1745
Practice Address - Country:US
Practice Address - Phone:319-465-6702
Practice Address - Fax:319-465-6727
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA34205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1023096567Medicaid
IA4212399Medicaid
IA2212399Medicaid
IA3212399Medicaid
IA3212399Medicaid
H41341Medicare UPIN