Provider Demographics
NPI:1962606897
Name:MARY SCHWARTZ, DPM. PC.
Entity type:Organization
Organization Name:MARY SCHWARTZ, DPM. PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:574-935-4068
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563-0278
Mailing Address - Country:US
Mailing Address - Phone:574-316-0306
Mailing Address - Fax:574-239-0478
Practice Address - Street 1:112 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563-1744
Practice Address - Country:US
Practice Address - Phone:574-316-0306
Practice Address - Fax:574-239-0478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000938213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0007273484OtherAETNA
IN200353690Medicaid
IN000000521416OtherANTHEM
INP00403293OtherMEDICARE RAILROAD
IN000000521416OtherANTHEM
IN251580AMedicare PIN