Individual
DR. DALLAS STURDEVANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3186
Mailing address
407 SHORTLEAF TRL, MARTINEZ, GA 30907-3364
(307) 851-3699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13836
GA
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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