Provider Demographics
NPI:1174594089
Name:SCHWARTZ, MITCHELL S (MD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:S
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 HIGHWAY 35 SUITE 1
Mailing Address - Street 2:SHORE GASTROENTEROLOGY ASSOCIATES
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2760
Mailing Address - Country:US
Mailing Address - Phone:732-517-0060
Mailing Address - Fax:732-548-7408
Practice Address - Street 1:1907 HIGHWAY 35 SUITE 1
Practice Address - Street 2:SHORE GASTROENTEROLOGY ASSOCIATES
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2760
Practice Address - Country:US
Practice Address - Phone:732-517-0060
Practice Address - Fax:732-548-7408
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA52741207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ67255OtherGHI PROVIDER #
NJO515604Medicaid
NJ100004695OtherRAILROAD MEDICARE
NJ443048OtherCIGNA PROVIDER #
NJMS083OtherOXFORD PROVIDER #
NJ919473OtherHEALTHNET PROVIDER #
NJ0193579000OtherAMERIHEALTH PROVIDER
NJ222921463OtherBCBS PROVIDER #
NJ4225558OtherAETNA PROVIDER #
NJ100004695OtherRAILROAD MEDICARE
NJ222921463OtherBCBS PROVIDER #