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General NPI Number Information
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NPI Number | 1306274352
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Entity Type | Organization
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Legal Business Name | SHVARTS PSYCHIATRIC SERVICES, P.C.
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 1400 BUFORD HWY BLDG R R-6
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City | BUFORD
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State | GA
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Zip | 30518-8721
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Country | US
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Telephone | 678-288-9339
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Fax | 678-802-3123
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Provider Business Mailing Address
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Address Line | 4996 PRICE DR
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City | SUWANEE
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State | GA
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Zip | 30024-4186
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Country | US
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Telephone | 678-288-9339
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Fax | 678-802-3123
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MRS. POLINA P SHVARTS
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Credential | M.D.
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Telephone | 678-288-9339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 068560
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License Number State | GA
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