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General NPI Number Information
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NPI Number | 1972918050
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Entity Type | Organization
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Legal Business Name | GEORGIA BREAST SURGERY PC
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Dates
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Enumeration Date | 06/26/2014
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Last Update Date | 08/13/2014
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Provider Practice Location Address
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Address Line | 631 PROFESSIONAL DR SUITE 240
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3367
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Country | US
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Telephone | 706-613-5171
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Fax | 706-613-2816
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Provider Business Mailing Address
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Address Line | 631 PROFESSIONAL DR SUITE 240
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3367
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Country | US
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Telephone | 706-613-5171
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Fax | 706-613-2816
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEAN-CLAUDE SCHWARTZ
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Credential | MD
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Telephone | 706-613-5171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 62768
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License Number State | GA
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