Provider Demographics
NPI:1700854353
Name:SCHWARTZ, WENDY N (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:N
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W BROAD ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4235
Mailing Address - Country:US
Mailing Address - Phone:703-538-3444
Mailing Address - Fax:703-538-4669
Practice Address - Street 1:103 W BROAD ST
Practice Address - Street 2:SUITE 120
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4235
Practice Address - Country:US
Practice Address - Phone:703-538-3444
Practice Address - Fax:703-538-4669
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101033010207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC62793Medicare UPIN
VA00B997F04Medicare PIN