Provider Demographics
NPI:1295850451
Name:SCHORMAN, DEIRDRE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:DEIRDRE
Middle Name:MARIE
Last Name:SCHORMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:35 DANBURY RD
Mailing Address - Street 2:UNIT 5 WILTON MEDICAL WALK IN CLINIC INC
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897
Mailing Address - Country:US
Mailing Address - Phone:203-834-8885
Mailing Address - Fax:203-834-8889
Practice Address - Street 1:35 DANBURY RD
Practice Address - Street 2:UNIT 5 WILTON MEDICAL WALK IN CLINIC INC
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897
Practice Address - Country:US
Practice Address - Phone:203-834-8885
Practice Address - Fax:203-834-8889
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT000272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
040000272CT01OtherBCBS
061545354OtherHMC
OV4868OtherHEALTHNET
110007531Medicare PIN
061545354OtherHMC