MEDICARE: DR. STEPHANIE A STEGALL M.D.

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	208000000X	Pediatrics Physician	30169	TN

General Provider Information

NPI Number	:	1578538013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE A STEGALL M.D.

Provider Business Mailing Address
First Line	:	929 SPRING CREEK RD
Second Line	:	SUITE 206
City	:	CHATTANOOGA
State	:	TN
Zip	:	37412-3964
Country	:	US
Telephone Number	:	423-892-3400
Fax Number	:	423-892-8266

Provider Business Practice Location Address
First Line	:	929 SPRING CREEK RD
Second Line	:	SUITE 206
City	:	CHATTANOOGA
State	:	TN
Zip	:	37412-3964
Country	:	US
Telephone Number	:	423-892-3400
Fax Number	:	423-892-8266

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

Provider Enumeration Date	:	02/20/2006
Last Update Date	:	07/08/2007

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