Provider Demographics
NPI:1669470449
Name:SCHWARTZMAN, MITCHELL A (DO)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:A
Last Name:SCHWARTZMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6122 TORRESDALE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-3718
Mailing Address - Country:US
Mailing Address - Phone:215-338-6677
Mailing Address - Fax:215-338-9935
Practice Address - Street 1:6122 TORRESDALE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-3718
Practice Address - Country:US
Practice Address - Phone:215-338-6677
Practice Address - Fax:215-338-9935
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003680L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA050390FBWMedicare PIN