Healthcare Provider Details

I. General information

NPI: 1942552930
Provider Name (Legal Business Name): DAVID ABRAHAM SHWALB PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2012
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36MDOS/SGOW (MENTAL HEALTH SERVICES) ANDERSEN AFB, GUAM UNIT 14010
APO AP
96543-4010
US

IV. Provider business mailing address

ATTN: CAPT SHWALB, 36MDOS/SGOW ANDERSEN AFB, GUAM UNIT 14010
APO AP
96543-4010
US

V. Phone/Fax

Practice location:
  • Phone: 671-366-5125
  • Fax:
Mailing address:
  • Phone: 671-366-5125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: