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General NPI Number Information
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NPI Number | 1790724433
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Entity Type | Individual
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Provider Name | MARK FREDERICK STEGELMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1356 WAYNE AVE NE
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City | ATLANTA
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State | GA
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Zip | 30306-3233
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Country | US
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Telephone | 404-881-6600
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Fax | 404-881-1066
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Provider Business Mailing Address
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Address Line | PO BOX 133091
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City | ATLANTA
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State | GA
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Zip | 30333-3091
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Country | US
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Telephone | 404-881-6600
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Fax | 404-881-1066
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 034721
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME89382
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 18853
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 27667
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | NC
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