Individual
DR. MARY CHRYSSIADIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3441 SE WILLOUGHBY BLVD, STUART, FL 34994-5060
(772) 597-3687
(772) 597-4604
Mailing address
PO BOX 267, 16401 SW FARMS ROAD, INDIANTOWN, FL 34956-0267
(772) 597-3687
(772) 597-4604
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME 69427
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G54955
MEDICAL LICENSE
CA
01
—
ME69427
MEDICAL LICENSE
FL
Enumeration date
03/24/2006
Last updated
07/08/2007
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