=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609216886
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GORDON FRANCIS SCHWARTZ MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2013
-----------------------------------------------------
Last Update Date | 07/02/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 237 S 18TH ST # 21-D
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19103-6161
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-830-9991
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 237 S 18TH ST # 21-D
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19103-6161
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | GORDON SCHWARTZ
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 215-830-9991
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086X0206X
-----------------------------------------------------
Taxonomy Name | Surgical Oncology Physician
-----------------------------------------------------
License Number | MD009977E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------