Healthcare Provider Details

I. General information

NPI: 1174505465
Provider Name (Legal Business Name): LYNDETTA R SCHWARTZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 LEITER RD
MIAMISBURG OH
45342-3659
US

IV. Provider business mailing address

2115 LEITER RD
MIAMISBURG OH
45342-3659
US

V. Phone/Fax

Practice location:
  • Phone: 937-384-6800
  • Fax: 937-384-6939
Mailing address:
  • Phone: 937-384-6800
  • Fax: 937-384-6939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35059318
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: