Stevenson, Charles Edward

Stevenson, Charles Edward is an individual health care provider with primary practice located at 804 Dixie St , Carrollton GA 30117-4416. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Stevenson, Charles Edward can be contacted via phone (770) 834-0606.

Contact Information

Primary practice address
804 Dixie St Carrollton GA 30117-4416
Phone: (770) 834-0606
Fax: (770) 834-1833
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 016288 Georgia

Profile Details

NPI number 1548243801
LBN Legal business name Stevenson, Charles Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548243801 NPPES
Georgia MEDICAID 00222725A

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