Healthcare Provider Details

I. General information

NPI: 1912054404
Provider Name (Legal Business Name): MANFRED LUDWIG SCHWARZ D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 N WASHINGTON AVE
SAGINAW MI
48601-1211
US

IV. Provider business mailing address

3243 E MOORE RD
SAGINAW MI
48601-9346
US

V. Phone/Fax

Practice location:
  • Phone: 989-757-0867
  • Fax: 989-757-1597
Mailing address:
  • Phone: 989-777-4878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number5101008987
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: