Individual
DR. BRIANNA STADSVOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2273
Mailing address
1814 VERDERY ST, AUGUSTA, GA 30904-5716
(229) 251-3814
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10776
GA
Other
Enumeration date
04/14/2019
Last updated
04/14/2019
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