Provider Demographics
NPI:1285672527
Name:SCHWARTZ, PAUL (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
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 1:3512 NEWLAND RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2512
Mailing Address - Country:US
Mailing Address - Phone:410-978-8343
Mailing Address - Fax:410-889-2491
Practice Address - Street 1:3512 NEWLAND RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2512
Practice Address - Country:US
Practice Address - Phone:410-978-8343
Practice Address - Fax:410-889-2491
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD17118207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD361961300Medicaid
MDD73862Medicare UPIN
MD7600Medicare PIN