Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 036-114623 | IL |
N | 207XS0106X | Orthopaedic Hand Surgeon | 036-114623 | IL |
NPI | 1134326770 |
---|---|
Provider Name | Edric G Schwartz |
First Address | Milwaukee, WI 53278 |
Second Address | Rockford, IL 61107-5090 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036114623 | (05) | IL |
P00786161 | RR MEDICARE (01) | IL |