Provider Demographics
NPI:1396722096
Name:SCHWARTZ, MONTE J (MD)
Entity type:Individual
Prefix:
First Name:MONTE
Middle Name:J
Last Name:SCHWARTZ
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 1:1200 N. EL DORADO PLACE
Mailing Address - Street 2:F-670
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4637
Mailing Address - Country:US
Mailing Address - Phone:520-324-4774
Mailing Address - Fax:520-324-2567
Practice Address - Street 1:6226 E PIMA
Practice Address - Street 2:#3
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-7002
Practice Address - Country:US
Practice Address - Phone:520-320-1200
Practice Address - Fax:520-322-1222
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33951174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ951899Medicaid
AZ951899Medicaid
H07471Medicare UPIN