Organization
IDC MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN KYLE STELLBAUER (CEO)
(678) 347-2153
Entity
Organization
Contact information
Practice address
5400 LAUREL SPRINGS PKWY STE 1404, SUWANEE, GA 30024-6098
(678) 347-2153
Mailing address
5400 LAUREL SPRINGS PKWY STE 1404, SUWANEE, GA 30024-6098
(678) 347-2153
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
03/26/2019
Last updated
09/09/2022
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