Provider Demographics
NPI:1528036506
Name:SCHWARTZ, TERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE.
Mailing Address - Street 2:OPHTHALMOLOGY ML 4008
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-636-4751
Mailing Address - Fax:513-636-7911
Practice Address - Street 1:3333 BURNET AVE.
Practice Address - Street 2:OPHTHALMOLOGY ML 4008
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3039
Practice Address - Country:US
Practice Address - Phone:513-636-4751
Practice Address - Fax:513-636-7911
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0048346207W00000X
WV14309207W00000X
OH35.097295207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0095172000Medicaid
MD52-1759220OtherEYE DOCTORS OF WASHINGTON TAX ID
MD52-1759220OtherEYE DOCTORS OF WASHINGTON TAX ID
E19513Medicare UPIN