Provider Demographics
NPI:1275564585
Name:SCHWARZE, ROBERT F (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:SCHWARZE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 GRAHAM RD
Mailing Address - Street 2:BUILDING 2, SUITE 1110
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-8028
Mailing Address - Country:US
Mailing Address - Phone:314-831-2464
Mailing Address - Fax:314-831-9301
Practice Address - Street 1:1224 GRAHAM RD
Practice Address - Street 2:BUILDING 2, SUITE 1110
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-8028
Practice Address - Country:US
Practice Address - Phone:314-831-2464
Practice Address - Fax:314-831-9301
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9B32207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000002809Medicare ID - Type Unspecified
MOE22291Medicare UPIN
MO000001455Medicare ID - Type Unspecified