Healthcare Provider Details

I. General information

NPI: 1811485030
Provider Name (Legal Business Name): STEPHEN SCHWARTZ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 02/21/2022
Certification Date: 02/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SPRUCE ST PINE 1 WEST
PHILADELPHIA PA
19107-6130
US

IV. Provider business mailing address

800 SPRUCE ST PINE 1 WEST
PHILADELPHIA PA
19107-6130
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-7817
  • Fax: 215-829-7129
Mailing address:
  • Phone: 215-829-7817
  • Fax: 215-829-7129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS021330
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: