Provider Demographics
NPI:1134743289
Name:SCHWAB, BEN A
Entity type:Individual
Prefix:
First Name:BEN
Middle Name:A
Last Name:SCHWAB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 50TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1617
Mailing Address - Country:US
Mailing Address - Phone:515-225-3261
Mailing Address - Fax:515-225-1944
Practice Address - Street 1:1355 50TH ST
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1617
Practice Address - Country:US
Practice Address - Phone:515-225-3261
Practice Address - Fax:515-225-1944
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-05864207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine