Individual
STEPHANIE AMBROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 PEACHTREE ST NE, SUITE 1135, ATLANTA, GA 30308-2212
(404) 727-9610
(404) 712-1540
Mailing address
2015 UPPERGATE DR, ATLANTA, GA 30322-0001
(404) 785-3373
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
75594
GA
390200000X
Student in an Organized Health Care Education/Training Program
0116023541
VA
Other
Enumeration date
02/07/2011
Last updated
06/23/2016
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