Individual
DR. CARLA MAVOURNEEN SCHWALM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301089412
MI
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
38863
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174722912
—
IA
01
—
175150040
MEDICARE
IA
Enumeration date
07/12/2007
Last updated
11/27/2023
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