Provider Demographics
NPI:1205837887
Name:SCHWERDT, PAUL T (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:T
Last Name:SCHWERDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WASHINGTON ST.
Mailing Address - Street 2:STE. 220
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-255-0561
Mailing Address - Fax:781-255-0681
Practice Address - Street 1:825 WASHINGTON ST.
Practice Address - Street 2:STE. 220
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062
Practice Address - Country:US
Practice Address - Phone:781-255-0561
Practice Address - Fax:781-255-0681
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2008-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD11417174400000X
MA203570207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2030918Medicaid
RI411585OtherBLUE CHIP OF RI
RI6149-4OtherBLUE CROSS OF RI
MAJ22936OtherBCBS BLUE CROSS BLUE SHIELD
MA2030918Medicaid
MAOX1148Medicare PIN
RI6149-4OtherBLUE CROSS OF RI
RI7056471Medicare ID - Type Unspecified