Organization
MIGUEL E. STUBBS, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL E STUBBS MD (CEO)
(404) 803-5246
Entity
Organization
Contact information
Practice address
4760 AUSTELL RD STE 1, AUSTELL, GA 30106-2007
(404) 803-5146
(770) 991-5012
Mailing address
6724 CHURCH ST STE 3, RIVERDALE, GA 30274-4711
(770) 991-6186
(770) 991-5012
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060300I
—
GA
01
—
N688290
INTERNAL MEDICINE
GA
Enumeration date
08/16/2017
Last updated
06/16/2018
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