Provider Demographics
NPI:1407863657
Name:SCHWARTZ, JEFFREY V (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:V
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 1:3460 MAYLAND CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1449
Mailing Address - Country:US
Mailing Address - Phone:804-346-3077
Mailing Address - Fax:804-915-2328
Practice Address - Street 1:3460 MAYLAND CT
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1449
Practice Address - Country:US
Practice Address - Phone:804-346-3077
Practice Address - Fax:804-915-2328
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049639207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00W199J01Medicare ID - Type Unspecified
F56115Medicare UPIN