Individual
JEFFREY R SCHWAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
590 NANCY ST NW, MARIETTA, GA 30060-1334
(770) 423-0395
(770) 499-0352
Mailing address
590 NANCY ST NW, MARIETTA, GA 30060-1334
(770) 423-0395
(770) 499-0352
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
045119
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00906188A
—
GA
01
—
020050127
RAILROAD MEDICARE
GA
01
—
2583204
AETNA HMO ID
GA
01
—
52841049-001
BC/BS ID
GA
01
—
7372231
AETNA PPO ID
GA
Enumeration date
05/01/2006
Last updated
10/17/2019
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