Healthcare Provider Details

I. General information

NPI: 1760487698
Provider Name (Legal Business Name): DANIEL J SCHLITZER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 BRIGHAM ST
NEW BEDFORD MA
02740-2208
US

IV. Provider business mailing address

60 BRIGHAM ST
NEW BEDFORD MA
02740-2208
US

V. Phone/Fax

Practice location:
  • Phone: 508-999-6245
  • Fax: 508-999-9823
Mailing address:
  • Phone: 508-999-6245
  • Fax: 508-999-9823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number52466
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: