Provider Demographics
NPI:1700920493
Name:NATHAN H SCHWARTZ DPM PC
Entity Type:Organization
Organization Name:NATHAN H SCHWARTZ DPM PC
Other - Org Name:CENTER FOR FOOT AND ANKLE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:770-434-7078
Mailing Address - Street 1:861 WINDY HILL RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-1903
Mailing Address - Country:US
Mailing Address - Phone:770-434-7078
Mailing Address - Fax:770-434-0189
Practice Address - Street 1:861 WINDY HILL RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-1903
Practice Address - Country:US
Practice Address - Phone:770-434-7078
Practice Address - Fax:770-434-0189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000400213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6975850OtherCIGNA
GA393711OtherBCBS
GA000006102FMedicaid
GA4031414OtherAETNA POS PPO
GA3606057OtherAETNA HMO
GA4031414OtherAETNA POS PPO
GAU26298Medicare UPIN
GA000006102FMedicaid
GA48SCCQRMedicare ID - Type UnspecifiedMEDICARE INDIVIDUAL ID
GAP00161112Medicare PIN