Healthcare Provider Details

I. General information

NPI: 1346411667
Provider Name (Legal Business Name): HARVEY E SCHUCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 BRENTWOOD DR NE
ATLANTA GA
30305-3204
US

IV. Provider business mailing address

427 BRENTWOOD DR NE
ATLANTA GA
30305-3204
US

V. Phone/Fax

Practice location:
  • Phone: 404-261-2727
  • Fax:
Mailing address:
  • Phone: 404-261-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number043769
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: