Provider Demographics
NPI:1275550782
Name:SCHWARTZ, BENJAMIN D (MD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:D
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-286-2635
Mailing Address - Fax:314-286-2338
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM RHEUMATOLOGY, STE 5C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-286-2635
Practice Address - Fax:314-286-2338
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR7313207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200867034Medicaid
IL0354672136Medicaid
MO153010183Medicaid
MO153010183Medicare PIN