Healthcare Provider Details

I. General information

NPI: 1063479715
Provider Name (Legal Business Name): ROBERT E. SCHWARTZ JR. P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1434 PORTER ST BAHC
FORT DETRICK MD
21702-9210
US

IV. Provider business mailing address

18209 SUMMERLIN DR
HAGERSTOWN MD
21740-9581
US

V. Phone/Fax

Practice location:
  • Phone: 301-619-4670
  • Fax: 301-619-7676
Mailing address:
  • Phone: 301-797-4977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: