Provider Demographics
NPI:1164684379
Name:POUCH, STEPHANIE MARIE (MD, MS)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:POUCH
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Gender:F
Credentials:MD, MS
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Mailing Address - Street 1:101 WOODRUFF CIRCLE
Mailing Address - Street 2:WOODRUFF MEMORIAL RESEARCH BUILDING SUITE 201
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-712-7988
Mailing Address - Fax:404-712-2278
Practice Address - Street 1:101 WOODRUFF CIRCLE
Practice Address - Street 2:WOODRUFF MEMORIAL RESEARCH BUILDING, SUITE 2101
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-712-7988
Practice Address - Fax:404-712-2278
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-29
Last Update Date:2020-04-14
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Provider Licenses
StateLicense IDTaxonomies
ILC6454207R00000X
OH35123764207RI0200X
GA077760207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine