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NPI Code Detail

MEDICARE: DR. PETIE ANN SCHWERDTFEGER M.D.

MEDICARE: DR. PETIE ANN SCHWERDTFEGER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician21712OK

General Provider Information

NPI Number : 1811980402
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETIE ANN SCHWERDTFEGER M.D.
Provider Business Mailing Address
First Line : 485 N KS HWY 2
Second Line :
City : ANTHONY
State : KS
Zip : 67003-2526
Country : US
Telephone Number : 620-914-1200
Fax Number : 620-914-1257
Provider Business Practice Location Address
First Line : 485 N KS HWY 2
Second Line :
City : ANTHONY
State : KS
Zip : 67003-2526
Country : US
Telephone Number : 620-914-1200
Fax Number : 620-914-1257
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 11/24/2020

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