MEDICARE: AMY SCHWARTZBAUM

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	363A00000X	Physician Assistant	C05901	MD

General Provider Information

NPI Number	:	1467820902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY SCHWARTZBAUM

Provider Business Mailing Address
First Line	:	1003 W 7TH ST STE 200
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21701-4106
Country	:	US
Telephone Number	:	301-245-6300
Fax Number	:	301-682-2539

Provider Business Practice Location Address
First Line	:	1003 W 7TH ST STE 200
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21701-4106
Country	:	US
Telephone Number	:	301-245-6300
Fax Number	:	301-682-2539

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

Provider Enumeration Date	:	09/14/2015
Last Update Date	:	08/24/2021

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