Provider Demographics
NPI:1629031463
Name:SCHWARTZ, MARTIN LEE (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:LEE
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 COLUMBIANA RD
Mailing Address - Street 2:SUITE 4400
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-2153
Mailing Address - Country:US
Mailing Address - Phone:205-824-8000
Mailing Address - Fax:205-824-8111
Practice Address - Street 1:810 SAINT VINCENTS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1601
Practice Address - Country:US
Practice Address - Phone:205-939-7855
Practice Address - Fax:205-824-8111
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL124622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051526105Medicaid
AL51526105OtherBLUE CROSS/BLUE SHIELD
AL051526949Medicaid
AL51526107OtherBLUE CROSS/BLUE SHIELD
AL51526949OtherBLUE CROSS BLUE SHIELD
AL51526105Medicare ID - Type Unspecified