Healthcare Provider Details

I. General information

NPI: 1427180231
Provider Name (Legal Business Name): DAVID M. SCHWARTZ PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1827 POWERS FERRY RD SE BUILDING 22, SUITE 200
ATLANTA GA
30339-5621
US

IV. Provider business mailing address

1964 REGENTS WAY
MARIETTA GA
30062-4672
US

V. Phone/Fax

Practice location:
  • Phone: 770-953-4744
  • Fax: 770-953-4640
Mailing address:
  • Phone: 770-973-7401
  • Fax: 770-973-7420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1165
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: