Provider Demographics
NPI:1700930021
Name:SCHWARTZ, SHAWN KERRI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:KERRI
Last Name:SCHWARTZ
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 1:5001 BRIDLE LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3438
Mailing Address - Country:US
Mailing Address - Phone:402-471-4444
Mailing Address - Fax:402-479-5408
Practice Address - Street 1:801 W PROSPECTOR PL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-1970
Practice Address - Country:US
Practice Address - Phone:402-471-4444
Practice Address - Fax:402-479-5408
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16086207QA0505X
CO25127207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEE56850Medicare UPIN
NE274617Medicare ID - Type Unspecified