Provider Demographics
NPI:1467820902
Name:SCHWARTZBAUM, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SCHWARTZBAUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 W 7TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4106
Mailing Address - Country:US
Mailing Address - Phone:301-245-6300
Mailing Address - Fax:301-682-2539
Practice Address - Street 1:1003 W 7TH ST STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4106
Practice Address - Country:US
Practice Address - Phone:301-245-6300
Practice Address - Fax:301-682-2539
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05901363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant