Provider Demographics
NPI:1225141591
Name:SHINDELL, STEVE M (PHD)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:M
Last Name:SHINDELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3200 DOWNWOOD CIR NW
Mailing Address - Street 2:STE 230
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-1610
Mailing Address - Country:US
Mailing Address - Phone:404-605-0485
Mailing Address - Fax:404-605-9695
Practice Address - Street 1:3200 DOWNWOOD CIR NW
Practice Address - Street 2:STE 230
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1610
Practice Address - Country:US
Practice Address - Phone:404-605-0485
Practice Address - Fax:404-605-9695
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPSY001321103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAR80940Medicare UPIN