Provider Demographics
NPI:1275563884
Name:SCHWORM, RICHARD MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MARC
Last Name:SCHWORM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARC
Other - Middle Name:
Other - Last Name:SCHWORM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1303 SW FIRST AMERICAN PL
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-4059
Mailing Address - Country:US
Mailing Address - Phone:785-234-2306
Mailing Address - Fax:785-234-2550
Practice Address - Street 1:1303 SW FIRST AMERICAN PL
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-4059
Practice Address - Country:US
Practice Address - Phone:785-234-2306
Practice Address - Fax:785-234-2550
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-307472085R0204X
NE229762085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS103784OtherBC/BS PREMIER BLUE
KS200265610CMedicaid
KS200265610CMedicaid
KS103784Medicare PIN