Provider Demographics
NPI:1376584656
Name:SCHWARTZ, MICHAEL W (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 W WAYZATA BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LONG LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55356-4100
Mailing Address - Country:US
Mailing Address - Phone:952-473-3588
Mailing Address - Fax:
Practice Address - Street 1:1865 W WAYZATA BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LONG LAKE
Practice Address - State:MN
Practice Address - Zip Code:55356-4100
Practice Address - Country:US
Practice Address - Phone:952-473-3588
Practice Address - Fax:952-697-0752
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor