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NPI Code Detail

MEDICARE: DR. MARK FREDERICK STEGELMAN M.D.

MEDICARE:  DR. MARK FREDERICK STEGELMAN  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
1208000000XPediatrics Physician034721GA
2208000000XPediatrics PhysicianME89382FL
3208000000XPediatrics Physician18853MS
4208000000XPediatrics Physician27667SC
5208000000XPediatrics PhysicianNC

General Provider Information

NPI Number : 1790724433
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK FREDERICK STEGELMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 133091
Second Line :
City : ATLANTA
State : GA
Zip : 30333-3091
Country : US
Telephone Number : 404-881-6600
Fax Number : 404-881-1066
Provider Business Practice Location Address
First Line : 1356 WAYNE AVE NE
Second Line :
City : ATLANTA
State : GA
Zip : 30306-3233
Country : US
Telephone Number : 404-881-6600
Fax Number : 404-881-1066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MARK FREDERICK STEGELMAN M.D.” Practice Location

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