Provider Demographics
NPI:1124041967
Name:SWARTZ, STEPHEN LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LOUIS
Last Name:SWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7 SOLOMON PIERCE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-2535
Mailing Address - Country:US
Mailing Address - Phone:781-862-3134
Mailing Address - Fax:781-862-0699
Practice Address - Street 1:150 SOUTH HUNTINGTON AVE,
Practice Address - Street 2:VA HEALTHCARE SYSTEM
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:857-364-6252
Practice Address - Fax:857-364-6561
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA45569207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2095289Medicaid
MAE05322Medicare ID - Type UnspecifiedPROVIDER NUMBER
MAD82824Medicare UPIN