1558310268 NPI number — DR. ERIC L SCHWARTZMAN MD

Table of content: DR. ERIC L SCHWARTZMAN MD (NPI 1558310268)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558310268 NPI number — DR. ERIC L SCHWARTZMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARTZMAN
Provider First Name:
ERIC
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558310268
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1134 N ROAD ST
Provider Second Line Business Mailing Address:
STE 9
Provider Business Mailing Address City Name:
ELIZABETH CITY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27909-3365
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-331-1100
Provider Business Mailing Address Fax Number:
252-338-9170

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
612 KINGSBOROUGH SQUARE
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23320-5041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-547-9294
Provider Business Practice Location Address Fax Number:
757-548-0092
Provider Enumeration Date:
05/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0001X , with the licence number:  0101051351 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 2021-01664 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0000X , with the licence number: 0101051351 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 178642 . This is a "ANTHEM BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "CIGNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 3134410 . This is a "UHC/MAMSI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 00676 . This is a "BC/BS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 10029737 . This is a "SENTARA/OPTIMA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 5900676 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: PAR . This is a "MULTIPLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1094242 . This is a "USA MANAGED CARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "FIRST HEALTH COMMERCIAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 349276 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 96262 . This is a "OPTIMA/SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "CORVEL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: -001 . This is a "TRICARE/CHAMPUS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 067YF . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1558310268 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7334771 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "VA HEALTH NETWORK" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: PAR . This is a "VA PREMIER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010249279 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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