Basic Information
| Provider Information | |||||||||
| NPI: | 1417044314 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHWARZ | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1340 HAL GREER BLVD | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257013804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043996727 | ||||||||
| FaxNumber: | 3043996726 | ||||||||
| Practice Location | |||||||||
| Address1: | 1120 15TH ST | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309123800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067218623 | ||||||||
| FaxNumber: | 7067211459 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 04/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 006205 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | A-1471-08 | NM | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 49117-21 | WI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 11519 | MT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | DR.0046034 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 3010 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 86318 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 3010 | WV | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 0141820 | 05 | OH | MEDICAID | 7100373240 | 05 | KY | MEDICAID | 3810029635 | 05 | WV | MEDICAID | 838940 | 05 | AZ | MEDICAID |