Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 275133 | MA |
NPI | 1134125727 |
---|---|
Provider Name | Thomas A. Schwann |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1273 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 26/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F40860 | (02) |