Provider Demographics
NPI:1558303875
Name:STAHLMAN, JON E (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:E
Last Name:STAHLMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2390 WALL ST SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2186
Mailing Address - Country:US
Mailing Address - Phone:770-922-5696
Mailing Address - Fax:770-922-4353
Practice Address - Street 1:2390 WALL ST SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2186
Practice Address - Country:US
Practice Address - Phone:770-922-5696
Practice Address - Fax:770-922-4353
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA049207207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG58015Medicare UPIN