Provider Demographics
NPI:1639311640
Name:SHASSBERGER, STEPHEN ROBERT
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ROBERT
Last Name:SHASSBERGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22335 US HIGHWAY 72 STE C
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-2611
Mailing Address - Country:US
Mailing Address - Phone:256-233-5000
Mailing Address - Fax:256-233-5361
Practice Address - Street 1:22335 US HIGHWAY 72 STE C
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-2611
Practice Address - Country:US
Practice Address - Phone:256-233-5000
Practice Address - Fax:256-233-5361
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.1362207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology