Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 000572 | CT |
NPI | 1104812841 |
---|---|
Provider Name | Dr. Andrew Eric Schwartz |
First Address | Sharon, CT 06069-2010 |
Second Address | Salisbury, CT 06068-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 25/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030000572CT01 | BLUE SHIELD (01) | CT |
U18030 | (02) | CT |