Provider Demographics
NPI:1669494217
Name:SCHWINDT, MITCHEL G (MD)
Entity type:Individual
Prefix:
First Name:MITCHEL
Middle Name:G
Last Name:SCHWINDT
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 1:1705 ANNE ST NW # 5
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-6151
Mailing Address - Country:US
Mailing Address - Phone:218-333-4700
Mailing Address - Fax:218-333-4766
Practice Address - Street 1:1705 ANNE ST NW # 5
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-6151
Practice Address - Country:US
Practice Address - Phone:218-333-4700
Practice Address - Fax:218-333-4766
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN43443207PT0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN038751700Medicaid
MN038751700Medicaid
H24797Medicare UPIN