Provider Demographics
NPI:1649202078
Name:SCHWARTZ, STANLEY S (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:S
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 1:233 E. LANCASTER AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2321
Mailing Address - Country:US
Mailing Address - Phone:610-642-6800
Mailing Address - Fax:610-642-6850
Practice Address - Street 1:233 E LANCASTER AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2321
Practice Address - Country:US
Practice Address - Phone:610-642-6800
Practice Address - Fax:610-642-6850
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015605E207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA202681OtherMEDICARE ID
PA1025671250001Medicaid
PA202681OtherMEDICARE ID