Healthcare Provider Details
I. General information
NPI: 1730168303
Provider Name (Legal Business Name): EDWARD J SCHWAGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/12/2006
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1230 S CHERRYBELL STRA
TUCSON AZ
85713-1907
US
IV. Provider business mailing address
839 W CONGRESS ST
TUCSON AZ
85745-2819
US
V. Phone/Fax
- Phone: 520-670-3909
- Fax: 520-309-2560
- Phone: 520-670-3909
- Fax: 520-309-2560
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | 14949 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 14949 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: