Provider Demographics
NPI:1417044314
Name:SCHWARZ, STEPHANIE ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ELIZABETH
Last Name:SCHWARZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 DORR ST # MS 840
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-4040
Mailing Address - Country:US
Mailing Address - Phone:419-383-5330
Mailing Address - Fax:419-383-6235
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-3811
Practice Address - Fax:419-383-2918
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA86318207R00000X
AZ006205207R00000X
NMA-1471-08207R00000X
CODR.0046034207R00000X
WV3010207R00000X, 208M00000X
WI49117-21207R00000X
MT11519207R00000X
OH34.015557208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ838940Medicaid
OH0141820Medicaid
WV3810029635Medicaid
KY7100373240Medicaid
KY7100373240Medicaid
AZZ161876Medicare PIN