Provider Demographics
NPI:1306878228
Name:SCHWARTZBERG, LEE S (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:S
Last Name:SCHWARTZBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 MILL ST # M14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-2821
Practice Address - Street 1:75 PRINGLE WAY STE 801
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-8400
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-2821
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV21637207RH0000X, 207RH0003X, 207RX0202X
TN17969207RH0003X
MS12259207RH0003X
ARN7811207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00112463Medicaid
MO203033105Medicaid
4064434OtherAETNA
TN0072169OtherBCBS TN
AR113877001Medicaid
NV1306878228Medicaid
AR90175OtherBCBS AR
TN3027312Medicaid
TN110070710Medicare PIN
A99124Medicare UPIN
MO203033105Medicaid