Provider Demographics
NPI:1992733281
Name:SCHWARTZ, I DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:I
Middle Name:DAVID
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 505164
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-5164
Mailing Address - Country:US
Mailing Address - Phone:417-829-4620
Mailing Address - Fax:417-829-4316
Practice Address - Street 1:1965 S FREMONT AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2201
Practice Address - Country:US
Practice Address - Phone:417-820-0280
Practice Address - Fax:417-820-0290
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC221152080P0205X
MOR3M812080P0205X
NC2010-004662080P0205X
PAMD4808102080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOPENDINGOtherRR MEDICARE #
MO1992733281Medicaid
SCT63017Medicaid
OK200565320AMedicaid
MO1992733281Medicaid
MO132680215Medicare PIN
OK200565320AMedicaid
SCE727132389Medicare PIN