Basic Information
Provider Information
NPI: 1780662361
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SZABO
FirstName: STEPHEN
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1835 SAVOY DR
Address2: SUITE 300
City: ATLANTA
State: GA
PostalCode: 303411072
CountryCode: US
TelephoneNumber: 6782889555
FaxNumber: 6782889556
Practice Location
Address1: 6300 HOSPITAL PKWY
Address2: SUITE 300
City: JOHNS CREEK
State: GA
PostalCode: 300971828
CountryCode: US
TelephoneNumber: 7706238965
FaxNumber: 7706234018
Other Information
ProviderEnumerationDate: 01/04/2006
LastUpdateDate: 03/06/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X044850GAY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

ID Information
IDTypeStateIssuerDescription
000892185E05GA MEDICAID
000892185F05GA MEDICAID


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