Individual
DIANA STILLWAGON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3190 NORTHEAST EXPWY ACCESS RD, CHAMBLEE, GA 30341
(770) 451-5990
Mailing address
4157 DARBY WAY, DULUTH, GA 30096
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
146008
GA
Other
Enumeration date
05/03/2006
Last updated
07/08/2007
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