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General NPI Number Information
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NPI Number | 1336188598
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Entity Type | Individual
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Provider Name | DAVID M LAHASKY M. D.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 790 CHURCH ST NE STE 325
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City | MARIETTA
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State | GA
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Zip | 30060-7282
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Country | US
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Telephone | 770-419-7074
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Fax | 770-427-0180
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Provider Business Mailing Address
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Address Line | 790 CHURCH ST NE STE 325
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City | MARIETTA
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State | GA
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Zip | 30060-7282
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Country | US
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Telephone | 770-419-7074
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Fax | 770-427-0180
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 032225
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License Number State | GA
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