Healthcare Provider Details

I. General information

NPI: 1134124498
Provider Name (Legal Business Name): JOEL D. SCHWARTZ D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JOEL D SCHWARTZ DPM

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 06/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8984 DARROW RD STE 2
TWINSBURG OH
44087-2186
US

IV. Provider business mailing address

5373 KILBOURNE DR
LYNDHURST OH
44124-3744
US

V. Phone/Fax

Practice location:
  • Phone: 330-425-4888
  • Fax: 330-425-0702
Mailing address:
  • Phone: 440-461-0074
  • Fax: 330-425-0702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number36-00-1440-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: