Individual
ROBERT BRUCE SCHWALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1140 MONROE AVE NW, SUITE 150, GRAND RAPIDS, MI 49503-1055
(616) 459-1560
(616) 459-1560
Mailing address
PO BOX 632745, CINCINNATI, CINCINNATI, OH 45263-2745
(513) 559-2898
(513) 475-5415
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35045428
OH
207P00000X
Emergency Medicine Physician
Primary
35510
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000317075
ANTHEM
OH
01
—
000000319946
ANTHEM
OH
05
—
0515811
—
OH
05
—
863392
—
KY
01
—
P00126487
MEDICARE RAILROAD
OH
01
—
P00172166
MEDICARE RAILROAD
OH
Enumeration date
02/27/2006
Last updated
01/26/2010
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