Provider Demographics
NPI:1881655132
Name:SCHWEMM, HEATHER N (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:N
Last Name:SCHWEMM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FODEN RD WEST
Mailing Address - Street 2:STE 203
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106
Mailing Address - Country:US
Mailing Address - Phone:207-828-0361
Mailing Address - Fax:207-874-1483
Practice Address - Street 1:72 MAIN ST
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-7021
Practice Address - Country:US
Practice Address - Phone:207-467-8909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016539207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
023062OtherANTHEM
ME413380099Medicaid
3608379OtherAETNA
ME0723Medicare ID - Type Unspecified
MEMX9160Medicare PIN
ME413380099Medicaid