Individual
DR. STEFAN KENNETH ERCEG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B.B.S.
Contact information
Practice address
1380 MILSTEAD AVE, SUITE G, CONYERS, GA 30012
(770) 388-7745
(770) 922-0526
Mailing address
1380 MILSTEAD AVE, SUITE G, CONYERS, GA 30012
(770) 388-7745
(770) 922-0526
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
64371
GA
207L00000X
Anesthesiology Physician
Primary
64371
GA
208VP0014X
Interventional Pain Medicine Physician
64371
GA
208VP0014X
Interventional Pain Medicine Physician
MD0000045009
TN
Other
Enumeration date
02/13/2009
Last updated
11/01/2016
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