Provider Demographics
NPI:1245264795
Name:SCHWARZENBERG, SARAH JANE (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:SCHWARZENBERG
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 1:420 DELAWARE ST SE, MMC 185
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-624-1133
Mailing Address - Fax:612-626-0639
Practice Address - Street 1:420 DELAWARE ST SE, MMC 185
Practice Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-624-1133
Practice Address - Fax:612-626-0639
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28812208000000X, 2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
29-71651OtherMEDICA PRIMARY
100903OtherPREFERRED ONE
MT0056729Medicaid
OH0243794Medicaid
MN280577400Medicaid
MN2T318SCOtherBCBS
764311OtherARAZ/PPO
MNHP14355OtherHEALTHPARTNERS
NE41184394337Medicaid
NY01100421Medicaid
IA1963058Medicaid
100937OtherUCARE
2913328OtherMEDICA CHOICE
D82206Medicare UPIN
NY01100421Medicaid