Provider Demographics
NPI:1548479264
Name:JERRY SCHWARTZ, MD INTERNAL MEDICINE
Entity type:Organization
Organization Name:JERRY SCHWARTZ, MD INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-737-8657
Mailing Address - Street 1:7395 S PECOS RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3768
Mailing Address - Country:US
Mailing Address - Phone:702-737-8657
Mailing Address - Fax:702-737-5446
Practice Address - Street 1:7395 S PECOS RD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3768
Practice Address - Country:US
Practice Address - Phone:702-737-8657
Practice Address - Fax:702-737-5446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6541207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1063598183Medicare ID - Type UnspecifiedPHYSICIAN
NV1881721702Medicare ID - Type UnspecifiedPHYSICIAN
NV1700924297Medicare ID - Type UnspecifiedPHYSICIAN