Provider Demographics
NPI:1114913142
Name:SCHWARTZ, STEVEN B (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MAMMOTH RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-4133
Mailing Address - Country:US
Mailing Address - Phone:603-624-4380
Mailing Address - Fax:603-624-4805
Practice Address - Street 1:275 MAMMOTH RD
Practice Address - Street 2:SUITE 4
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-4133
Practice Address - Country:US
Practice Address - Phone:603-624-4380
Practice Address - Fax:603-624-4805
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6357207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2084478OtherAETNA PIN
NHP706837OtherOXFORD PIN
NHD03379OtherHPHC PIN
NH406456OtherTUFTS PIN
NHD03379OtherUPIN FOR ANTHEM REFFERALS
NH80000129Medicaid
NH0441900OtherUHC PIN
NH2980OtherCIGNA PIN
NH2980OtherCIGNA PIN
NHD03379OtherHPHC PIN