Healthcare Provider Details

I. General information

NPI: 1265252712
Provider Name (Legal Business Name): GWINNETT SURGICAL SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2024
Last Update Date: 10/10/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MEDICAL CENTER BLVD
LAWRENCEVILLE GA
30046-8708
US

IV. Provider business mailing address

500 MEDICAL CENTER BLVD STE 330
LAWRENCEVILLE GA
30046-3332
US

V. Phone/Fax

Practice location:
  • Phone: 770-762-9977
  • Fax: 770-339-9804
Mailing address:
  • Phone: 770-762-9977
  • Fax: 770-339-9804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEAN-CLAUDE DAVID SCHWARTZ
Title or Position: OWNER
Credential: MD
Phone: 912-531-9885