Provider Demographics
NPI:1962424341
Name:SCHWARTZ, ROBERT J (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
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:PO BOX 710
Mailing Address - Street 2:SPRINGFIELD MEDICAL CARE SYSTEMS INC
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-0710
Mailing Address - Country:US
Mailing Address - Phone:802-875-2546
Mailing Address - Fax:
Practice Address - Street 1:55 VT RT 11W
Practice Address - Street 2:CHESTER FAMILY MEDICINE
Practice Address - City:CHESTER
Practice Address - State:VT
Practice Address - Zip Code:05143
Practice Address - Country:US
Practice Address - Phone:802-875-2546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010903207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1011730Medicaid
VT1011730Medicaid
VTVN3773Medicare Oscar/Certification