Provider Demographics
NPI:1790772697
Name:SCHWARTZ, LOUIS W (DO)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:W
Last Name:SCHWARTZ
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 1:174 TIMBER TRACE LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-1034
Mailing Address - Country:US
Mailing Address - Phone:248-378-0071
Mailing Address - Fax:
Practice Address - Street 1:27355 JOHN R RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-3300
Practice Address - Country:US
Practice Address - Phone:248-291-2698
Practice Address - Fax:248-374-0567
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4391850-11Medicaid
MIOH26262 024Medicare ID - Type Unspecified
MI4391850-11Medicaid