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General NPI Number Information
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NPI Number | 1164378071
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Entity Type | Individual
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Provider Name | TEGAN STUBER
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Gender | Female
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Dates
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Enumeration Date | 03/05/2026
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Last Update Date | 03/05/2026
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Provider Practice Location Address
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Address Line | 1263 COBB PKWY N
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City | MARIETTA
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State | GA
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Zip | 30062-2421
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Country | US
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Telephone | 770-852-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 111 LINDEN LN
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City | LEXINGTON
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State | NC
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Zip | 27292-4864
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3401X
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Taxonomy Name | Computed Tomography Radiologic Technologist
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License Number |
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License Number State | GA
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