Provider Demographics
NPI:1740324284
Name:SCHWARTZ, PHILIP (PSYD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 BURTON ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2706
Mailing Address - Country:US
Mailing Address - Phone:301-385-8620
Mailing Address - Fax:240-450-3307
Practice Address - Street 1:8609 2ND AVE
Practice Address - Street 2:SUITE 201-B
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3360
Practice Address - Country:US
Practice Address - Phone:301-385-8620
Practice Address - Fax:240-450-3307
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3686103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical