Susan Gail Staviss
M.D. | Pediatric Adolescent Medicine | Female
Susan Gail Staviss, M.D. is a Marietta, Georgia based Pediatric doctor with medical specialization in
Pediatric Adolescent Medicine.
Current practice location of Susan Gail Staviss is
3939 Roswell Rd, Suite 300, Marietta, Georgia - 30062-6251. She can be contacted on phone at
770-578-2868 and fax number 770-971-8499.
Susan Gail Staviss is a sole proprietor of her business.
NPI number (Unique professional ID) for Susan Gail Staviss is
1346242229 which was assigned by NPPES on 11 Aug, 2005 and it was last updated on 02 Oct, 2019.
Susan Gail Staviss license number is
038652 for Pediatrics Adolescent Medicine (2080A0000X) in Georgia.
Susan Gail Staviss specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Susan Gail Staviss basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Susan Gail Staviss |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Susan Gail Staviss address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 3939 Roswell Rd, Suite 300
Marietta, GA, 30062-6251
United States |
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| Phone Number : | 770-578-2868 |
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| Fax Number : | 770-971-8499 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1346242229 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 11 Aug, 2005 |
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| Last Updated On : | 02 Oct, 2019 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Susan Gail Staviss are as mentioned. Primary taxonomy code for Susan Gail Staviss, M.D. is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 038652 | GA |
Legacy Identifiers:
Other legacy medical identifiers of Susan Gail Staviss such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 4508167 | Other | GA | AETNA USHEALTHCARE |
| 000607703D | MEDICAID | GA | |
| 3308662027 | Other | GA | CIGNA |
| 241020 | Other | GA | PRIVATE HEALTHCARE SYSTEM |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
205 HAWKINS STORE RD NW STE B1,
KENNESAW, GA, 30144-6215
United States | KENNESAW, GA | 770-928-0862 |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | sstaviss28195@directwellstar.org
| No affiliation |
|
| 205 HAWKINS STORE RD NW STE B1,
KENNESAW, GA, 30144-6215
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 3939 Roswell Rd, Suite 300
Marietta, GA, 30062-6251
United States |
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| Phone Number : | 770-578-2868 |
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| Fax Number : | 770-971-8499 |
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Business Location:
Patients can refer following map for directions to
Susan Gail Staviss practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.