1992385686 NPI number — DR. BRIANNA SCHWARCZ DO

Table of content: DR. BRIANNA SCHWARCZ DO (NPI 1992385686)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992385686 NPI number — DR. BRIANNA SCHWARCZ DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARCZ
Provider First Name:
BRIANNA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

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:
1992385686
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
221 N MAIN ST APT 312
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROYAL OAK
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48067-4110
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-464-1428
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26850 PROVIDENCE PKWY STE 505
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NOVI
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48374-1267
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-465-4163
Provider Business Practice Location Address Fax Number:
248-465-4359
Provider Enumeration Date:
04/08/2021

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: 207R00000X , with the licence number:  5101027762 , 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: 1992385686 . This is a "NPI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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