Basic Information
| Provider Information | |||||||||
| NPI: | 1982964458 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHWARTZ | ||||||||
| FirstName: | CODY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ACC CLINIC CB 7705 | ||||||||
| Address2: | 102 MASON FARM RD | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199661459 | ||||||||
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| Practice Location | |||||||||
| Address1: | ACC CLINIC CB 7705 | ||||||||
| Address2: | 102 MASON FARM RD | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199661459 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2012 | ||||||||
| LastUpdateDate: | 02/09/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 182449 | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2085U0001X | 2014-01721 | NC | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound |
No ID Information.