Provider Demographics
NPI:1447759972
Name:EUDIAMONDIA, PLLC
Entity Type:Organization
Organization Name:EUDIAMONDIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STONER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:229-392-7331
Mailing Address - Street 1:112 ELLSWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-7228
Mailing Address - Country:US
Mailing Address - Phone:229-392-7331
Mailing Address - Fax:
Practice Address - Street 1:112 ELLSWORTH CIR
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-7228
Practice Address - Country:US
Practice Address - Phone:229-392-7331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-10
Last Update Date:2018-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty