Provider Demographics
NPI:1881678811
Name:SCHWARTZ, GAYLE SWISSMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:SWISSMAN
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1920 GREENSPRING DR
Mailing Address - Street 2:NUMBER 125
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4112
Mailing Address - Country:US
Mailing Address - Phone:410-308-4900
Mailing Address - Fax:410-308-4960
Practice Address - Street 1:1920 GREENSPRING DR
Practice Address - Street 2:NUMBER 125
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4112
Practice Address - Country:US
Practice Address - Phone:410-308-4900
Practice Address - Fax:410-308-4960
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038079208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD549441900Medicaid
E64827Medicare UPIN
JD70Medicare ID - Type Unspecified