Healthcare Provider Details

I. General information

NPI: 1235138942
Provider Name (Legal Business Name): STEPHEN CRAIG FROHWEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5669 PEACHTREE DUNWOODY RD NE SUITE 315
ATLANTA GA
30342-1786
US

IV. Provider business mailing address

1838 AMERICAN WAY
LAWRENCEVILLE GA
30043-6611
US

V. Phone/Fax

Practice location:
  • Phone: 678-843-6400
  • Fax: 678-843-6405
Mailing address:
  • Phone: 770-995-7622
  • Fax: 770-995-7854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number034834
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: