Provider Demographics
NPI:1851354005
Name:SCHWARTZ, ROBERT I (DPM)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:I
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CIRCLE 75 PKWY SE
Mailing Address - Street 2:STE. 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3035
Mailing Address - Country:US
Mailing Address - Phone:678-426-2171
Mailing Address - Fax:404-446-1957
Practice Address - Street 1:3949 HOLCOMB BRIDGE RD.
Practice Address - Street 2:STE. 100
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2294
Practice Address - Country:US
Practice Address - Phone:770-449-1122
Practice Address - Fax:770-449-3547
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000453213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I488301Medicare PIN
GAT91137Medicare UPIN
GA480021677OtherRAILROAD MEDICARE
GACN7503OtherRAILROAD MEDICARE
GA0430650010Medicare NSC
GAGRP655Medicare PIN
GA00893428A-HMedicaid