Provider Demographics
NPI:1407960305
Name:SCHWERTSCHLAG, ULLRICH (MD)
Entity Type:Individual
Prefix:
First Name:ULLRICH
Middle Name:
Last Name:SCHWERTSCHLAG
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 1:3 STONE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2173
Mailing Address - Country:US
Mailing Address - Phone:978-921-5237
Mailing Address - Fax:
Practice Address - Street 1:3 STONE RIDGE RD
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2173
Practice Address - Country:US
Practice Address - Phone:978-921-5237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81959207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine