Provider Demographics
NPI:1255322335
Name:SCHWARTZ, NORMAN A (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:A
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:PO BOX 164055
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43216-4055
Mailing Address - Country:US
Mailing Address - Phone:614-252-2191
Mailing Address - Fax:614-252-2194
Practice Address - Street 1:621 BROAD ST SW
Practice Address - Street 2:1E
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-8118
Practice Address - Country:US
Practice Address - Phone:740-927-5060
Practice Address - Fax:740-927-5730
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350569245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0760645Medicaid
OH080020764OtherRR MEDICARE
OH080020764OtherRR MEDICARE
OH0672751Medicare PIN
OH0672756Medicare PIN