Provider Demographics
NPI:1154403095
Name:SCHWEMER, CULLEN R (MD)
Entity type:Individual
Prefix:
First Name:CULLEN
Middle Name:R
Last Name:SCHWEMER
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 1:855 MANKATO AVENUE
Mailing Address - Street 2:PO BOX 5600
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-0006
Mailing Address - Country:US
Mailing Address - Phone:507-454-3650
Mailing Address - Fax:504-457-4160
Practice Address - Street 1:855 MANKATO AVENUE
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-0006
Practice Address - Country:US
Practice Address - Phone:507-454-3650
Practice Address - Fax:504-457-4160
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN444832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN58G17SCOtherBCBS
WI34171200OtherMA
C46064Medicare UPIN