Provider Demographics
NPI:1053325456
Name:SCHWARTZ, ALLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 MOSSY BARK CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-4276
Mailing Address - Country:US
Mailing Address - Phone:702-510-0152
Mailing Address - Fax:
Practice Address - Street 1:5850 POLARIS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3182
Practice Address - Country:US
Practice Address - Phone:702-739-9957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2009-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO 538207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCJ073YMedicare UPIN
NVBK083BMedicare PIN
NVCJ073ZMedicare UPIN
NVBK083AMedicare PIN