Provider Demographics
NPI:1699724856
Name:SCHWORM, WENDI S (PA-C)
Entity type:Individual
Prefix:
First Name:WENDI
Middle Name:S
Last Name:SCHWORM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W PEARL ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-1332
Mailing Address - Country:US
Mailing Address - Phone:419-424-0380
Mailing Address - Fax:
Practice Address - Street 1:200 W PEARL ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1332
Practice Address - Country:US
Practice Address - Phone:419-424-0380
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-00-1536363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA16681Medicare ID - Type Unspecified