MEDICARE: BRUCE S STAMBLER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	35-075577	OH
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	35-075577	OH
3	207RC0001X	Clinical Cardiac Electrophysiology Physician	072698	GA

General Provider Information

NPI Number	:	1144240219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE S STAMBLER MD

Provider Business Mailing Address
First Line	:	275 COLLIER ROAD, NW
Second Line	:	SUITE 500
City	:	ATLANTA
State	:	GA
Zip	:	30309-1711
Country	:	US
Telephone Number	:	404-605-2800
Fax Number	:	404-351-5983

Provider Business Practice Location Address
First Line	:	275 COLLIER ROAD, NW
Second Line	:	SUITE 500
City	:	ATLANTA
State	:	GA
Zip	:	30309-1711
Country	:	US
Telephone Number	:	216-844-8500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	12/14/2015

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Directions to “ BRUCE S STAMBLER MD” Practice Location

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