Provider Demographics
NPI:1740306943
Name:EINSTEIN, ALAN DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DAVID
Last Name:EINSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5750 MILLWICK DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-6741
Mailing Address - Country:US
Mailing Address - Phone:678-575-5129
Mailing Address - Fax:678-513-1147
Practice Address - Street 1:3333 OLD MILTON PKWY STE 170
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-0008
Practice Address - Country:US
Practice Address - Phone:678-513-2228
Practice Address - Fax:678-513-1147
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 6892207R00000X
GA40900207R00000X
GA040900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGA 040900OtherGA MEDICAL LICENSE
FLOS 6892OtherFL LICENSE
GA00737338BMedicaid
GA00737338BMedicaid
GA11BDPWFMedicare ID - Type Unspecified
GABE4502375OtherDEA LICENSE