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General NPI Number Information
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NPI Number | 1174518393
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Entity Type | Individual
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Provider Name | MARY ELLEN SCHWARTZ DPM
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Gender | Female
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 08/08/2019
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Provider Practice Location Address
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Address Line | 116 E WASHINGTON ST
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City | PLYMOUTH
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State | IN
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Zip | 46563-1744
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Country | US
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Telephone | 574-935-4068
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Fax | 574-935-4058
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Provider Business Mailing Address
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Address Line | 112 E WASHINGTON ST
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City | PLYMOUTH
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State | IN
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Zip | 46563-1744
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Country | US
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Telephone | 574-316-0306
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Fax | 574-239-0478
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 07000938A
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License Number State | IN
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