Provider Demographics
NPI:1073747465
Name:SCHOENBERG, EVAN D (MD)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:D
Last Name:SCHOENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE STREET
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2248
Mailing Address - Country:US
Mailing Address - Phone:404-897-6810
Mailing Address - Fax:404-897-4924
Practice Address - Street 1:550 PEACHTREE STREET
Practice Address - Street 2:SUITE 1500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2248
Practice Address - Country:US
Practice Address - Phone:404-897-6810
Practice Address - Fax:404-897-4924
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072101A207W00000X
GA072786207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology