Individual
MRS. STEPHANIE ROCK WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-1316
(912) 350-2156
Mailing address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-1316
(912) 350-2156
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007203
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003147243A
—
GA
05
—
1902PA
—
SC
01
—
P01336422
RAILROAD MEDICARE
GA
Enumeration date
04/08/2014
Last updated
08/27/2014
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