Basic Information
| Provider Information | |||||||||
| NPI: | 1063479715 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHWARTZ | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | E. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18209 SUMMERLIN DR | ||||||||
| Address2: | |||||||||
| City: | HAGERSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217409581 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017974977 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1434 PORTER ST | ||||||||
| Address2: | BAHC | ||||||||
| City: | FORT DETRICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217029210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016194670 | ||||||||
| FaxNumber: | 3016197676 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | Other Service Providers | Specialist |
No ID Information.