1548230527 NPI number — DAVID F SCHWARZ MD

Table of content: DAVID F SCHWARZ MD (NPI 1548230527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548230527 NPI number — DAVID F SCHWARZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARZ
Provider First Name:
DAVID
Provider Middle Name:
F
Provider Name Prefix Text:
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:
1548230527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9285 OAKVIEW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SWARTZ CREEK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48473-1019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-938-3623
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2420 OWEN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FENTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48430-3417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-496-2500
Provider Business Practice Location Address Fax Number:
810-629-0415
Provider Enumeration Date:
01/24/2006

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: 207Q00000X , with the licence number:  4301072821 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1006934 . This is a "MCLAREN HEALTH PLAN ID #" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0993375 . This is a "HEALTHPLUS ID #" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0250575 . This is a "BLUE CROSS & BCN ID #" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4443311 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 13904 . This is a "MCARE ID #" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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