Provider Demographics
NPI:1851319990
Name:SCHWAB, JOHN CONRAD (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CONRAD
Last Name:SCHWAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:667 KINGSBOROUGH SQ STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-4999
Mailing Address - Country:US
Mailing Address - Phone:757-842-4481
Mailing Address - Fax:757-312-3135
Practice Address - Street 1:300 MEDICAL PKWY STE 303
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4985
Practice Address - Country:US
Practice Address - Phone:757-842-6083
Practice Address - Fax:757-842-6125
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101058397207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7104524OtherMAMSI
VA5818656Medicaid
VA13480OtherSENTARA
VA13480OtherSENTARA
VA440000027Medicare ID - Type Unspecified