Provider Demographics
NPI:1215294194
Name:SCHWARTZ, DREW WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:DREW
Middle Name:WILLIAM
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6508 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-3014
Mailing Address - Country:US
Mailing Address - Phone:216-334-1401
Mailing Address - Fax:216-334-1409
Practice Address - Street 1:6508 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-3014
Practice Address - Country:US
Practice Address - Phone:216-334-1401
Practice Address - Fax:216-334-1409
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4263111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4263OtherOHIO STATE LICENSE