Provider Demographics
NPI:1982679940
Name:SWARTZ, MARK ALAN (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ALAN
Last Name:SWARTZ
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 1:761 5TH AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201
Mailing Address - Country:US
Mailing Address - Phone:717-261-1269
Mailing Address - Fax:717-261-0664
Practice Address - Street 1:761 5TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-261-1269
Practice Address - Fax:717-261-0664
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0393151E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
50003537OtherCAPITAL BLUE CROSS
50003537OtherCAPITAL BLUE CROSS
506607Medicare ID - Type Unspecified