Individual
MARY HARRIS STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1301 WELLBROOK CIRCLE, CONYERS, GA 30012-3873
(770) 922-3023
(770) 929-1016
Mailing address
1301 WELLBROOK CIRCLE, CONYERS, GA 30012-3873
(770) 922-3023
(770) 929-1016
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
029796
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00346992B
—
GA
Enumeration date
10/04/2006
Last updated
11/29/2017
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