Healthcare Provider Details

I. General information

NPI: 1881658854
Provider Name (Legal Business Name): MICHAEL A SCHWARZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 CAREW STREET SURGICAL PA DEPARTMENT
SPRINGFIELD MA
01104-2377
US

IV. Provider business mailing address

1601 LAMBROOK DR
DELAND FL
32724-7365
US

V. Phone/Fax

Practice location:
  • Phone: 413-748-7353
  • Fax: 413-748-7357
Mailing address:
  • Phone: 386-679-4944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9102063
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA7375
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: