Individual
DR. COREY S. GREENWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2711 IRVIN WAY, SUITE 211, DECATUR, GA 30030-5405
(404) 501-0001
(404) 501-0023
Mailing address
2711 IRVIN WAY, SUITE 211, DECATUR, GA 30030-5405
(404) 501-0001
(404) 501-0023
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
041130
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000703293A
—
GA
05
—
000703293B
—
GA
05
—
000703293C
—
GA
05
—
000703293D
—
GA
Enumeration date
08/02/2005
Last updated
02/08/2012
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