Provider Demographics
NPI:1629230735
Name:CP NEUROMONITORING, LLC
Entity Type:Organization
Organization Name:CP NEUROMONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:S
Authorized Official - Last Name:STEFANIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-741-3690
Mailing Address - Street 1:310 HOSPITAL DR STE 205
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-8025
Mailing Address - Country:US
Mailing Address - Phone:478-741-3690
Mailing Address - Fax:478-741-6404
Practice Address - Street 1:310 HOSPITAL DR STE 205
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-8025
Practice Address - Country:US
Practice Address - Phone:478-741-3690
Practice Address - Fax:478-741-6404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty