NPI Profile for KEIKO STOBAEUS in AUGUSTA, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical |
363AM0700X | 97 | Physician Assistant |
| NPI # | 1568935823 |
|
| Status | Active | |
| Credentials | PA-C (Physician Assistant-Certified) | |
| Entity | Individual | |
| Enumeration date | 01/09/2019 | |
| Last updated | 01/09/2020 - About 6 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) |
|
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KEIKO STOBAEUS
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