Healthcare Provider Details

I. General information

NPI: 1487826988
Provider Name (Legal Business Name): STEPHEN MICHAEL SZIROVECZ O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 NORTHPOINT CIR
ALPHARETTA GA
30022-4854
US

IV. Provider business mailing address

1114 NORTHPOINT CIR
ALPHARETTA GA
30022-4854
US

V. Phone/Fax

Practice location:
  • Phone: 770-667-8060
  • Fax: 770-667-2024
Mailing address:
  • Phone: 770-667-8060
  • Fax: 770-667-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1353
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: