Provider Demographics
NPI:1053395293
Name:SCHAVEY, DENISE (MD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SCHAVEY
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 1:1950 CENTER CREEK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-3428
Mailing Address - Country:US
Mailing Address - Phone:507-238-4968
Mailing Address - Fax:
Practice Address - Street 1:1950 CENTER CREEK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-3428
Practice Address - Country:US
Practice Address - Phone:507-238-4968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31854207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01-13060OtherMEDICA
MN109576Medicaid
MN5T430SCOtherBLUE PLUS
MNA018OtherCHAMPUS
MNHP29845OtherHEALTH PARTNERS
MN20884OtherSIOUX VALLEY
MN5T430SCOtherBCBS
MN5T430SCOtherBCBS/MEDICARE SUPPLEMENT
IA984120Medicaid
MN544275OtherARAZ
MN608888100Medicaid
MNMH9041000381OtherPPO
A03081Medicare UPIN
MN80013634Medicare ID - Type UnspecifiedMEDICARE
MN80013634Medicare NSC
MNHP29845OtherHEALTH PARTNERS