Provider Demographics
NPI:1194167452
Name:SCHWILKE, EUGENE
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:SCHWILKE
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 1:450 SOUTHLAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3094
Mailing Address - Country:US
Mailing Address - Phone:504-361-8989
Mailing Address - Fax:
Practice Address - Street 1:450 SOUTHLAKE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3094
Practice Address - Country:US
Practice Address - Phone:504-361-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician