Provider Demographics
NPI:1922104157
Name:SCHWARTZ, DAVID LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LOUIS
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 1:965 RIDGE LAKE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9446
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:6019 WALNUT GROVE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2113
Practice Address - Country:US
Practice Address - Phone:901-226-0340
Practice Address - Fax:901-226-0349
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS248462085R0001X
TN546682085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ024892Medicaid
MS00620760Medicaid
TNQ024892Medicaid
TN103I923508Medicare PIN
TNQ024892Medicaid
MS00620760Medicaid
TN103I923508Medicare PIN