Provider Demographics
NPI:1851393797
Name:SWARTZ, TIMOTHY JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOSEPH
Last Name:SWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 W CROSSTOWN PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-1999
Mailing Address - Country:US
Mailing Address - Phone:269-532-1590
Mailing Address - Fax:574-252-4161
Practice Address - Street 1:555 W CROSSTOWN PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008
Practice Address - Country:US
Practice Address - Phone:269-532-1590
Practice Address - Fax:574-252-4161
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301061084207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301061084OtherMICHIGAN LICENSE
MI102956532Medicaid
MI102956532Medicaid
MIAS3272159OtherDEA
MIC96066004Medicare PIN
MI102956532Medicaid