Provider Demographics
NPI:1508279134
Name:SCHACHTER, DANIEL MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MATTHEW
Last Name:SCHACHTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12 EXECUTIVE PARK DRIVE NE
Mailing Address - Street 2:DEPT OF NEUROLOGY, 2ND FLOOR
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30029
Mailing Address - Country:US
Mailing Address - Phone:404-778-7777
Mailing Address - Fax:
Practice Address - Street 1:12 EXECUTIVE PARK DRIVE
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY, 2ND FLOOR
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30029
Practice Address - Country:US
Practice Address - Phone:404-778-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125065113207R00000X, 2084N0400X
FLTPME1582084N0400X
GA832942084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLTPME158OtherFLORIDA MEDICAL LICENSE