Provider Demographics
NPI:1770518631
Name:SCHWARTZ, AUGUST MARTIN (PA)
Entity type:Individual
Prefix:
First Name:AUGUST
Middle Name:MARTIN
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3381 FIR TREE LN
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018-1211
Mailing Address - Country:US
Mailing Address - Phone:859-371-6162
Mailing Address - Fax:
Practice Address - Street 1:55 PROGRESS PL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-1715
Practice Address - Country:US
Practice Address - Phone:513-346-5000
Practice Address - Fax:513-671-8348
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50000081363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0864088Medicaid
OHSCPA25171Medicare ID - Type Unspecified