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Individual

GLENN RUDOLPH SCHWENK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12188 A NORTH MERIDIAN ST, SUITE 375, CARMEL, IN 46032-4578
(317) 926-1056
(317) 579-0476
Mailing address
12188 A NORTH MERIDIAN ST, SUITE 375, CARMEL, IN 46032-4578
(317) 926-1056
(317) 579-0476

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01030262A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000231409
BCBS
IN
05
100378730
IN
Enumeration date
08/01/2005
Last updated
12/23/2009
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