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General NPI Number Information
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NPI Number | 1811240054
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Entity Type | Organization
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Legal Business Name | RICHARD A. STAPPENBECK, M.D., P.C.
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 33 UPPER RIVERDALE RD SW SUITE 111
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City | RIVERDALE
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State | GA
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Zip | 30274-2626
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Country | US
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Telephone | 770-997-4018
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Fax | 770-997-8074
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Provider Business Mailing Address
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Address Line | 33 UPPER RIVERDALE RD SW SUITE 111
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City | RIVERDALE
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State | GA
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Zip | 30274-2626
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Country | US
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Telephone | 770-997-4018
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Fax | 770-997-8074
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Authorized Official
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Title or Position | RN
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Name | DEBBIE STAPPENBECK
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Credential |
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Telephone | 770-997-4018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 20825
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License Number State | GA
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