Basic Information
Provider Information
NPI: 1871682443
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHWARTZ
FirstName: DANIEL
MiddleName: STEPHEN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1120 15TH ST STE BI1056
Address2:  
City: AUGUSTA
State: GA
PostalCode: 309120004
CountryCode: US
TelephoneNumber: 7064465941
FaxNumber: 7067219286
Practice Location
Address1: 1120 15TH ST
Address2:  
City: AUGUSTA
State: GA
PostalCode: 30912
CountryCode: US
TelephoneNumber: 7067218623
FaxNumber: 7067211459
Other Information
ProviderEnumerationDate: 10/12/2006
LastUpdateDate: 09/11/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X241153NYN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XA98078CAN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XM9639TXN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X081313GAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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