Provider Demographics
NPI:1558414599
Name:STEVEN P. SCHWARTZ, O.D., P.A.
Entity Type:Organization
Organization Name:STEVEN P. SCHWARTZ, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-643-4277
Mailing Address - Street 1:101 LOG CANOE CIR
Mailing Address - Street 2:SUITE E
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21666-2106
Mailing Address - Country:US
Mailing Address - Phone:410-643-4277
Mailing Address - Fax:
Practice Address - Street 1:101 LOG CANOE CIR
Practice Address - Street 2:SUITE E
Practice Address - City:STEVENSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21666-2106
Practice Address - Country:US
Practice Address - Phone:410-643-4277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTAO643152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD801648801Medicaid
MD420635-3OtherCAREFIRSTBLUECROSSBLUESHIELD
MD420635-3OtherCAREFIRSTBLUECROSSBLUESHIELD
X681Medicare PIN
0181470001Medicare NSC