Grosswald, David L
Grosswald, David L is an individual health care provider with primary practice located at 1192 Dogwood Drive , Conyers GA 30012-5454. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Grosswald, David L can be contacted via phone (770) 860-1919.Contact Information
Primary practice address
1192 Dogwood Drive
Conyers GA 30012-5454
Phone: (770) 860-1919
Fax: (770) 860-1607
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | GA1327 | Georgia |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT001327 | Georgia |
Profile Details
| NPI number | 1770543720 |
|---|---|
| LBN Legal business name | Grosswald, David L |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Apr 27th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770543720 | NPPES |
| Georgia | MEDICAID | 628068295A |
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