Individual provider · NPI-1

Stephanie Ambrose, M.D.

Otolaryngology, Pediatric Otolaryngology · Atlanta, GA

NPI number1093011249
StatusActive
Last updated in NPPESJun 23, 2016

Details

NPI
1093011249
Entity type
Individual (NPI-1)
Name
Stephanie Ambrose
Credential
M.D.
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 7, 2011
Last updated
Jun 23, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207YP0228X Otolaryngology, Pediatric Otolaryngology75594GAYes
390200000X Student in an Organized Health Care Education/Training Program0116023541VA

Practice location

550 Peachtree St Ne
Suite 1135
Atlanta, GA 30308-2212

Phone 404-727-9610 · Fax 404-712-1540

Mailing address

2015 Uppergate Dr
Atlanta, GA 30322-0001

Phone 404-785-3373

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