MEDICARE: MRS. KATHRYN THERESA STANCHEV CSA, CST

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	246ZC0007X	Surgical Assistant

General Provider Information

NPI Number	:	1518393461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHRYN THERESA STANCHEV CSA, CST

Provider Business Mailing Address
First Line	:	402 HILL CREST WAY
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-2260
Country	:	US
Telephone Number	:	404-455-0278
Fax Number	:

Provider Business Practice Location Address
First Line	:	402 HILL CREST WAY
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-2260
Country	:	US
Telephone Number	:	404-455-0278
Fax Number	:

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

Provider Enumeration Date	:	09/24/2013
Last Update Date	:	04/23/2021

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