Provider Demographics
NPI:1699893628
Name:FESCHUK, DAVID CRAIG (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CRAIG
Last Name:FESCHUK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6740 JAMES B RIVERS DR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-2235
Mailing Address - Country:US
Mailing Address - Phone:404-775-9642
Mailing Address - Fax:
Practice Address - Street 1:6740 JAMES B RIVERS DR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-2235
Practice Address - Country:US
Practice Address - Phone:404-775-9642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAV01169Medicare UPIN