Provider Demographics
NPI:1750357091
Name:SCHWARTZ, IRA SANFORD (MD)
Entity type:Individual
Prefix:DR
First Name:IRA
Middle Name:SANFORD
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 BORTHWICK AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4174
Mailing Address - Country:US
Mailing Address - Phone:603-436-6115
Mailing Address - Fax:603-433-5567
Practice Address - Street 1:330 BORTHWICK AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4174
Practice Address - Country:US
Practice Address - Phone:603-436-6115
Practice Address - Fax:603-433-5567
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NHNH6334207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3088069Medicaid
NHNH015902Medicare PIN
NHE04396Medicare UPIN
NHRAILROAD P00746248Medicare PIN
NHP00746248OtherRAILROAD MEDICARE
NHNH015902Medicare PIN