Healthcare Provider Details

I. General information

NPI: 1831053867
Provider Name (Legal Business Name): DAGAN SCHWARTZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 STATE ST
BANGOR ME
04401-6616
US

IV. Provider business mailing address

27-18 URBAN PL
FAIR LAWN NJ
07410-3110
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-7000
  • Fax:
Mailing address:
  • Phone: 201-773-3194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35073794
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberMD30461
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: