Provider Demographics
NPI:1497730261
Name:SCHWARTZ, BRUCE H (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:H
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:707 N MICHIGAN ST
Mailing Address - Street 2:STE. 210
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46601-1067
Mailing Address - Country:US
Mailing Address - Phone:574-233-2114
Mailing Address - Fax:574-288-8921
Practice Address - Street 1:707 N MICHIGAN ST STE 210
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1069
Practice Address - Country:US
Practice Address - Phone:574-233-2114
Practice Address - Fax:574-288-8921
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01050719A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200208870AMedicaid
IN235010DMedicare ID - Type Unspecified