Provider Demographics
NPI:1508972688
Name:SAALWAECHTER, DAVID G
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:G
Last Name:SAALWAECHTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350C ATLANTA HWY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-3324
Mailing Address - Country:US
Mailing Address - Phone:334-279-7413
Mailing Address - Fax:334-279-7418
Practice Address - Street 1:5350C ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-3324
Practice Address - Country:US
Practice Address - Phone:334-279-7413
Practice Address - Fax:334-279-7418
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4941630001Medicare ID - Type Unspecified