Provider Demographics
NPI:1164606372
Name:SCHWARTZ, KENNETH M (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:M
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:410 SAYBROOK RD # C
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4777
Mailing Address - Country:US
Mailing Address - Phone:860-358-2970
Mailing Address - Fax:860-347-1630
Practice Address - Street 1:410 SAYBROOK RD # C
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4777
Practice Address - Country:US
Practice Address - Phone:860-358-2970
Practice Address - Fax:860-347-1630
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2025-11-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT051745208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery