Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | -0101237123 | VA |
N | 208000000X | Pediatrician | 0101237123 | VA |
NPI | 1700812708 |
---|---|
Provider Name | Dr. David J Schwartz |
First Address | Evans, GA 30809-6606 |
Second Address | Ft Gordon, GA 30905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/10/2013 |