Healthcare Provider Details

I. General information

NPI: 1669665154
Provider Name (Legal Business Name): DANIEL A. SCHWARZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 03/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18444 W 10 MILE RD SUITE 102
SOUTHFIELD MI
48075-2653
US

IV. Provider business mailing address

3537 PORT COVE DR
WATERFORD MI
48328-4512
US

V. Phone/Fax

Practice location:
  • Phone: 248-798-0368
  • Fax: 888-330-7328
Mailing address:
  • Phone: 734-330-7373
  • Fax: 888-330-7328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number4301062570
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number4301062570
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number4301062570
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: