Provider Demographics
NPI:1649266552
Name:CARMICHAEL, STEPHANIE C (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:C
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:755 COMMERCE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2627
Mailing Address - Country:US
Mailing Address - Phone:404-593-2739
Mailing Address - Fax:404-593-2746
Practice Address - Street 1:755 COMMERCE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2627
Practice Address - Country:US
Practice Address - Phone:404-593-2739
Practice Address - Fax:404-593-2746
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA036053207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00564088GMedicaid
GAF67760Medicare UPIN
GA00564088GMedicaid