Individual
DR. RAYMOND L STOVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 PROFESSIONAL DR, SUITE 150, LAWRENCEVILLE, GA 30046-8717
(678) 376-1800
(678) 376-5500
Mailing address
600 PROFESSIONAL DR, SUITE 150, LAWRENCEVILLE, GA 30046-8717
(678) 376-1800
(678) 376-5500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
025291
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00282675B
—
GA
01
—
10659984294
HUMANA
GA
01
—
182686
COVENTRY
GA
01
—
4031478
AETNA
GA
01
—
52450038
BLUE CROSS
GA
01
—
743055533
UNITED HEATLHCARE
GA
Enumeration date
08/08/2006
Last updated
12/15/2009
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