Organization
SOUTHERN COASTAL ENT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERMAN A STEVENSON MD (OWNER)
(912) 265-3210
Entity
Organization
Contact information
Practice address
2500 STARLING ST, SUITE 403, BRUNSWICK, GA 31520-4265
(912) 265-3210
(912) 265-1481
Mailing address
2500 STARLING ST, SUITE 403, BRUNSWICK, GA 31520-4265
(912) 265-3210
(912) 265-1481
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
057327
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078903405A
—
GA
Enumeration date
11/06/2006
Last updated
07/15/2008
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