Provider Demographics
NPI:1063582799
Name:SCHYBERG, JEFFREY P (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:P
Last Name:SCHYBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 E 65TH ST STE 18
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4492
Mailing Address - Country:US
Mailing Address - Phone:912-352-4842
Mailing Address - Fax:912-352-4844
Practice Address - Street 1:836 E 65TH ST STE 18
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4492
Practice Address - Country:US
Practice Address - Phone:912-352-4842
Practice Address - Fax:912-352-4844
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036278207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF44194Medicare UPIN
GA11BDNCLMedicare ID - Type Unspecified