Provider Demographics
NPI:1629050372
Name:SCHWABER, MITCHELL K (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:K
Last Name:SCHWABER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:SUITE LL-50
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:SUITE 400
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-297-2700
Practice Address - Fax:615-386-2197
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD13485207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN30228621Medicaid
TN4067886OtherAETNA
10604176OtherCIGNA
TN4166594OtherBCBS OF TN
TNTN0138OtherAMERICHOICE
TN01159184OtherAMERIGROUP
KY6479027200Medicaid
259244OtherUSA MANAGED CARE
TN1506114Medicaid
TN1506114Medicaid
TN103I049231Medicare PIN
30228621Medicare PIN