Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 4301062570 | MI |
NPI | 1669665154 |
---|---|
Provider Name | Dr. Daniel A. Schwarz |
First Address | Waterford, MI 48328-4512 |
Second Address | Southfield, MI 48075-2653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2007 |
Last Update Date | 11/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0931600 | BCBSM (01) | MI |