Provider Demographics
NPI:1902991797
Name:SCHWEDLER, PAMELA M (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:M
Last Name:SCHWEDLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-5509
Mailing Address - Country:US
Mailing Address - Phone:781-388-4160
Mailing Address - Fax:781-397-8715
Practice Address - Street 1:109 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5509
Practice Address - Country:US
Practice Address - Phone:781-388-4160
Practice Address - Fax:781-397-8715
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA262907363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner