Provider Demographics
NPI:1679820302
Name:CONFIDENCE MEDICAL ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:CONFIDENCE MEDICAL ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SCHWARM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-283-0266
Mailing Address - Street 1:1442 N 8TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-1027
Mailing Address - Country:US
Mailing Address - Phone:618-283-0266
Mailing Address - Fax:618-283-4081
Practice Address - Street 1:1442 N 8TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-1027
Practice Address - Country:US
Practice Address - Phone:618-283-0266
Practice Address - Fax:618-283-4081
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONFIDENCE MEDICAL ASSOCIATES, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036086476207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty