Provider Demographics
NPI:1205490745
Name:SCHWERIN, LYDIA
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:SCHWERIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5316 THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:METAMORA
Mailing Address - State:MI
Mailing Address - Zip Code:48455
Mailing Address - Country:US
Mailing Address - Phone:810-341-4982
Mailing Address - Fax:
Practice Address - Street 1:5316 THOMAS RD
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455
Practice Address - Country:US
Practice Address - Phone:810-341-4982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other