Individual
STACEY NICOLE DESAMOURS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3121 PANTHERSVILLE RD, DECATUR, GA 30034-3830
(404) 270-8186
Mailing address
3121 PANTHERSVILLE RD, DECATUR, GA 30034-3830
(404) 270-8186
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
62786
GA
Other
Enumeration date
07/13/2006
Last updated
08/12/2019
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