Basic Information
Provider Information | |||||||||
NPI: | 1194977199 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SCHWARTZ | ||||||||
FirstName: | MICHAEL | ||||||||
MiddleName: | BRIAN | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 5655 HUDSON DR STE 210 | ||||||||
Address2: | ARIS RADIOLOGY | ||||||||
City: | HUDSON | ||||||||
State: | OH | ||||||||
PostalCode: | 442364455 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3306551869 | ||||||||
FaxNumber: | 3306553828 | ||||||||
Practice Location | |||||||||
Address1: | 6525 BELCREST RD STE G50 | ||||||||
Address2: |   | ||||||||
City: | HYATTSVILLE | ||||||||
State: | MD | ||||||||
PostalCode: | 207822000 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3012095700 | ||||||||
FaxNumber: | 3012095776 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/21/2008 | ||||||||
LastUpdateDate: | 07/21/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 0101248881 | VA | N |   | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | D82907 | MD | N |   | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 390200000X | 241952-1 | NY | N |   | Student, Health Care | Student in an Organized Health Care Education/Training Program |   | 2085R0202X | MD044940 | DC | Y |   | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.