Provider Demographics
NPI:1013021658
Name:DAY, STEPHEN D (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:D
Last Name:DAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102846
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2846
Mailing Address - Country:US
Mailing Address - Phone:404-501-7925
Mailing Address - Fax:404-501-6638
Practice Address - Street 1:4367 SNAPFINFER WOODS DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035
Practice Address - Country:US
Practice Address - Phone:770-981-2100
Practice Address - Fax:770-808-8445
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA37784207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00125127OtherMEDICARE RAILROAD
GA00579389CMedicaid
GAF15308Medicare UPIN
GA08BDPNV01Medicare ID - Type Unspecified