Provider Demographics
NPI:1184631368
Name:MULLER-DALE, STEPHANIE BETH (MD, FAAP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:BETH
Last Name:MULLER-DALE
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:BETH
Other - Last Name:DALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, FAAP
Mailing Address - Street 1:3180 NORTH POINT PKWY, SUITE 410
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005
Mailing Address - Country:US
Mailing Address - Phone:770-664-0088
Mailing Address - Fax:770-664-8228
Practice Address - Street 1:3180 NORTH POINT PKWY, SUITE 410
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005
Practice Address - Country:US
Practice Address - Phone:770-664-0088
Practice Address - Fax:770-664-8228
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240064208000000X
GA059629208000000X
GA59629208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003136184AMedicaid