Basic Information
| Provider Information | |||||||||
| NPI: | 1174594089 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHWARTZ | ||||||||
| FirstName: | MITCHELL | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1907 HIGHWAY 35 SUITE 1 | ||||||||
| Address2: | SHORE GASTROENTEROLOGY ASSOCIATES | ||||||||
| City: | OAKHURST | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077552760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325170060 | ||||||||
| FaxNumber: | 7325487408 | ||||||||
| Practice Location | |||||||||
| Address1: | 1907 HIGHWAY 35 SUITE 1 | ||||||||
| Address2: | SHORE GASTROENTEROLOGY ASSOCIATES | ||||||||
| City: | OAKHURST | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077552760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325170060 | ||||||||
| FaxNumber: | 7325487408 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 03/31/2016 | ||||||||
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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 | 207RG0100X | MA52741 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 67255 | 01 | NJ | GHI PROVIDER # | OTHER | O515604 | 05 | NJ | MEDICAID | 100004695 | 01 | NJ | RAILROAD MEDICARE | OTHER | 443048 | 01 | NJ | CIGNA PROVIDER # | OTHER | MS083 | 01 | NJ | OXFORD PROVIDER # | OTHER | 919473 | 01 | NJ | HEALTHNET PROVIDER # | OTHER | 0193579000 | 01 | NJ | AMERIHEALTH PROVIDER | OTHER | 222921463 | 01 | NJ | BCBS PROVIDER # | OTHER | 4225558 | 01 | NJ | AETNA PROVIDER # | OTHER |