Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 5101014823 | MI |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 5101014823 | MI |
NPI | 1174637938 |
---|---|
Provider Name | David Matthew Schwartzenfeld |
First Address | Allen Park, MI 48101-2007 |
Second Address | Rochester Hills, MI 48307-5364 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 14/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080F340140 | BCBS OF MICHIGAN (01) | MI |
I61775 | (02) | MI |