Organization
LAKESIDE PSYCHIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE STALCUP MD (OWNER/AUTHORIZED OFFICIAL)
(919) 717-9673
Entity
Organization
Contact information
Practice address
5 WATER ST, SHREWSBURY, MA 01545-4228
(919) 717-9673
Mailing address
5 WATER ST, SHREWSBURY, MA 01545-4228
(919) 717-9673
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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