Provider Demographics
NPI:1477547131
Name:SCHWARTZMAN, MICHAEL A (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:SCHWARTZMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 119TH ST
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IN
Mailing Address - Zip Code:46394-1515
Mailing Address - Country:US
Mailing Address - Phone:219-659-3338
Mailing Address - Fax:219-659-3668
Practice Address - Street 1:1104 119TH ST
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:IN
Practice Address - Zip Code:46394-1515
Practice Address - Country:US
Practice Address - Phone:219-659-3338
Practice Address - Fax:219-659-3668
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000927A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN4788030001OtherMEDICARE -DMERC
IN90001073OtherBC/BS
IN1861660607OtherDMERC BILLING NPI
IL4788030002OtherMEDICARE-DMERC PTAN
IL016003402Medicaid
IN200347600AMedicaid
IL364166383TOtherBC IL
IN480032395OtherRAILROAD RETIREMENT- RRMC
INM100056616Medicare PIN
IN480032395OtherRAILROAD RETIREMENT- RRMC
IN1861660607OtherDMERC BILLING NPI
IL364166383TOtherBC IL
IN4788030001OtherMEDICARE -DMERC
ILIL5778001Medicare PIN
ILIL5779Medicare PIN