Healthcare Provider Details

I. General information

NPI: 1518351071
Provider Name (Legal Business Name): MARC SCHWARTZ MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE BCH, HUNNEWELL BLDG, PAVILION 129, HOUSESTAFF LOUNGE
BOSTON MA
02115-5724
US

IV. Provider business mailing address

450 BROOKLINE AVE
BOSTON MA
02215-5418
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-7793
  • Fax:
Mailing address:
  • Phone: 617-632-3270
  • Fax: 617-632-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number281254
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: