Provider Demographics
NPI:1134170707
Name:SCHWAB, CHRISTINE KEALA (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KEALA
Last Name:SCHWAB
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 1:701 PARK AVE. SO.
Mailing Address - Street 2:HCMC INTERNAL MEDICINE, G5
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-1829
Mailing Address - Country:US
Mailing Address - Phone:612-873-4455
Mailing Address - Fax:612-904-4527
Practice Address - Street 1:701 PARK AVE. SO.
Practice Address - Street 2:HCMC INTERNAL MEDICINE, G5
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-1829
Practice Address - Country:US
Practice Address - Phone:612-873-4455
Practice Address - Fax:612-904-4257
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN52058207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA22161OtherWELLMARK BCBS
IA0498840Medicaid
IAP00333755Medicare PIN
IAI17753Medicare PIN
IA0498840Medicaid