Provider Demographics
NPI:1699883587
Name:SCHOONOVER, CAROL HAGEN (MD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:HAGEN
Last Name:SCHOONOVER
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 1:6401 FRANCE AVE S
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2199
Mailing Address - Country:US
Mailing Address - Phone:952-924-5000
Mailing Address - Fax:
Practice Address - Street 1:6401 FRANCE AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2199
Practice Address - Country:US
Practice Address - Phone:952-924-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN41907207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN852909OtherAMERICA'S PPO
MNHP29195OtherHEALTHPARTNERS
MN1020469OtherPREFERRED ONE
MN74D54HAOtherBCBS OF MN
MN0401180OtherMEDICA
MN123706OtherUCARE MN
MN7147018OtherAETNA INS
MN283217800Medicaid
MN74D54HAOtherBCBS OF MN
MN110192767Medicare ID - Type UnspecifiedRR MEDICARE
MNH00378Medicare UPIN