Provider Demographics
NPI:1225007891
Name:SCHWAEGERLE, SONYA M (MD)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:M
Last Name:SCHWAEGERLE
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:PO BOX 1849
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04241-1849
Mailing Address - Country:US
Mailing Address - Phone:207-784-2554
Mailing Address - Fax:207-777-1439
Practice Address - Street 1:333 BORTHWICK AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7128
Practice Address - Country:US
Practice Address - Phone:603-433-4907
Practice Address - Fax:603-433-4910
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8102207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0102789Y0NH01OtherANTHEM BCBS
NH220017422OtherRAILROAD MEDICARE
MEA0108OtherANTHEM BCBS MAINE
NH30005142Medicaid
020461237OtherONE HEALTH PLAN
ME142110099Medicaid
NH008102OtherTUFTS HEALTH PLAN
E51792OtherHARVARD PILGRIM HEALTH
020461237OtherPHCS
020461237OtherHCVM
NH3671OtherHEALTHSOURCE
NH3671OtherHEALTHSOURCE
E51792Medicare UPIN