Provider Demographics
NPI:1144214602
Name:SCHWARTZ, JOHN R (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2201 BRUNSWICK DR STE 1300
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-8350
Mailing Address - Country:US
Mailing Address - Phone:717-632-2088
Mailing Address - Fax:717-646-7428
Practice Address - Street 1:2201 BRUNSWICK DR STE 1300
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-8350
Practice Address - Country:US
Practice Address - Phone:717-632-2088
Practice Address - Fax:717-646-7428
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS 010523L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001754588Medicaid
PA027319ZEA5Medicare PIN
PA001754588Medicaid