Provider Demographics
NPI:1174637938
Name:SCHWARTZENFELD, DAVID MATTHEW (D O)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MATTHEW
Last Name:SCHWARTZENFELD
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6825 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2007
Mailing Address - Country:US
Mailing Address - Phone:313-294-2941
Mailing Address - Fax:313-294-0437
Practice Address - Street 1:633 SOUTH BLVD E STE 1200
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5364
Practice Address - Country:US
Practice Address - Phone:248-705-6223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101014823207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080F340140OtherBCBS OF MICHIGAN
MII61775Medicare UPIN
MIP54930001Medicare PIN