Provider Demographics
NPI:1417997941
Name:SWARTZ, MITCHELL ROBERT (MD, SCD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:ROBERT
Last Name:SWARTZ
Suffix:
Gender:M
Credentials:MD, SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 81135
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-0001
Mailing Address - Country:US
Mailing Address - Phone:781-237-3625
Mailing Address - Fax:
Practice Address - Street 1:16 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-2247
Practice Address - Country:US
Practice Address - Phone:781-237-3625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA501342085R0001X, 2084P0800X
NY1781022085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry