Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 45800 | TN |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 74786 | GA |
NPI | 1073737656 |
---|---|
Provider Name | Dr. Chadwick William Stouffer |
First Address | Savannah, GA 31404-6220 |
Second Address | Savannah, GA 31404-6220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 27/01/2022 |