Provider Demographics
NPI:1700948312
Name:STOEVER, CHELSEA M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:M
Last Name:STOEVER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 EAST 70TH ST.
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-354-7622
Mailing Address - Fax:912-354-7628
Practice Address - Street 1:705 EAST 70TH ST.
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405
Practice Address - Country:US
Practice Address - Phone:912-354-7622
Practice Address - Fax:912-354-7628
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1122363A00000X
GA005056363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0481PAMedicaid
SCAA16428619Medicare PIN