Provider Demographics
NPI:1811918683
Name:SCHWARTZ, MICHAEL B (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:B
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:36 OLD KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4552
Mailing Address - Country:US
Mailing Address - Phone:203-662-8900
Mailing Address - Fax:203-662-8906
Practice Address - Street 1:36 OLD KINGS HWY S
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820
Practice Address - Country:US
Practice Address - Phone:203-662-8900
Practice Address - Fax:203-662-8906
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000319207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001003194Medicaid
CTF57537Medicare UPIN
CT001003194Medicaid