Provider Demographics
NPI:1942252218
Name:SCHWARTZ, DAVID PAUL (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 MAIN ST
Mailing Address - Street 2:PO BOX 13346
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-1636
Mailing Address - Country:US
Mailing Address - Phone:513-863-2273
Mailing Address - Fax:513-863-6022
Practice Address - Street 1:1199 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-1636
Practice Address - Country:US
Practice Address - Phone:513-863-2273
Practice Address - Fax:513-863-6022
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4154103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0748150Medicaid
OH0748150Medicaid
OHCP14992Medicare ID - Type Unspecified