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Individual

MR. ILYA SCHWARTZMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3581 CENTRAL AVE, COLUMBUS, IN 47203-2036
(812) 376-9601
(812) 378-8518
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037683
IN
207Q00000X
Family Medicine Physician
01037683A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000089434
ANTHEM
IN
01
000000990927
ANTHEM PIN
IN
01
003944
SIHO
05
100083410
IN
05
100083410A
IN
01
351896225
COMMERCIAL
01
351896225100
CARESOURCE
IN
Enumeration date
07/07/2006
Last updated
09/06/2024
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