Individual
DR. MARK COOPER STOVROFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
755 MOUNT VERNON HWY NE, SUITE 460, ATLANTA, GA 30328-4274
(404) 252-7900
(404) 252-7905
Mailing address
755 MOUNT VERNON HWY NE, SUITE 460, ATLANTA, GA 30328-4274
(404) 252-7900
(404) 252-7905
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
037088
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00552736D
—
GA
Enumeration date
07/21/2005
Last updated
10/03/2012
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