Provider Demographics
NPI:1851316277
Name:SCHWARTZ, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
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 1:5957 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05255-8913
Mailing Address - Country:US
Mailing Address - Phone:802-362-4440
Mailing Address - Fax:802-362-7146
Practice Address - Street 1:5957 MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255-8913
Practice Address - Country:US
Practice Address - Phone:802-362-4440
Practice Address - Fax:802-362-7146
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0008510207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN0355Medicaid
VTOVN0355Medicaid
VTE87954Medicare UPIN