Individual
STEPHEN CARL VATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, CRNA
Contact information
Practice address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
(865) 985-6110
Mailing address
2710 CONCORD RD, LA FAYETTE, GA 30728-5455
(865) 985-6110
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN309929
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/14/2020
Last updated
03/08/2022
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