Provider Demographics
NPI:1962496380
Name:SCHWER, NORBERT (MD)
Entity Type:Individual
Prefix:
First Name:NORBERT
Middle Name:
Last Name:SCHWER
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 1:423 SYCAMORE ST STE 103
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2374
Mailing Address - Country:US
Mailing Address - Phone:269-479-3030
Mailing Address - Fax:269-479-3032
Practice Address - Street 1:423 SYCAMORE ST STE 103
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2374
Practice Address - Country:US
Practice Address - Phone:269-479-3030
Practice Address - Fax:269-479-3032
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301053760208D00000X
IN01049415208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200183080Medicaid
IN200183080Medicaid
F42190Medicare UPIN
164560FMedicare ID - Type Unspecified