MEDICARE: ERIC R SCHWARTZKOPF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	19404	NE
2	207R00000X	Internal Medicine Physician	MD60390116	WA

General Provider Information

NPI Number	:	1346213238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC R SCHWARTZKOPF MD

Provider Business Mailing Address
First Line	:	PO BOX 32
Second Line	:
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99019-0032
Country	:	US
Telephone Number	:	509-529-8905
Fax Number	:	509-526-8402

Provider Business Practice Location Address
First Line	:	380 CHASE AVE
Second Line	:
City	:	WALLA WALLA
State	:	WA
Zip	:	99362-2924
Country	:	US
Telephone Number	:	509-525-8110
Fax Number	:	509-522-5743

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	03/25/2021

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