Individual
DR. ANTWAN STEPHERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1455 MORELAND AVE SE, ATLANTA, GA 30316-3128
(404) 622-1819
Mailing address
4111 FLAKES MILL MANOR LN, ELLENWOOD, GA 30294-1497
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
031762
GA
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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