Provider Demographics
NPI:1104953611
Name:SCHWEICKERT, LORI A (MD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:SCHWEICKERT
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 1:1903 N HARRISON AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2410
Mailing Address - Country:US
Mailing Address - Phone:919-677-0101
Mailing Address - Fax:919-677-0113
Practice Address - Street 1:1903 N HARRISON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2410
Practice Address - Country:US
Practice Address - Phone:919-677-0101
Practice Address - Fax:919-677-0113
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94003442084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8974813Medicaid