Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 9736 | MD |
NPI | 1013004845 |
---|---|
Provider Name | Dr. Conrad Albert Schwalm |
First Address | Silver Spring, MD 20906-2921 |
Second Address | Silver Spring, MD 20906-2921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |