Provider Demographics
NPI:1225087745
Name:INFECTIOUS DISEASE CONSULTANTS, PC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:STELLBAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-347-2153
Mailing Address - Street 1:5400 LAUREL SPRINGS PKWY STE 1404
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6098
Mailing Address - Country:US
Mailing Address - Phone:678-347-2153
Mailing Address - Fax:
Practice Address - Street 1:5400 LAUREL SPRINGS PKWY STE 1404
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6098
Practice Address - Country:US
Practice Address - Phone:678-347-2153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty