DR. DUSTIN ALLEN COPELAND STALOCH (NPI# 1184011645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184011645 |
| Entity Type | Individual |
| Full Name | DR. DUSTIN ALLEN COPELAND STALOCH |
| Credential | M.D |
| Practice Address |
1364 Clifton Rd Ne Atlanta GA 30307-2102 |
| Practice Telephone | 4047122000 |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2018-04-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 77317 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1364 CLIFTON RD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30307-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669476248 | Maureen E. Haas | Pharmacist | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2005-06-10 |
| 1730789900 | Gina Renae Martin | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-10-28 |
| 1053919878 | Yolanda Martin | Nurse Practitioner | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-10-14 |
| 1508463175 | Federico Andres Napoli | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-10-06 |
| 1871109330 | Jazmynn Lee Orellana-noia | Nurse Practitioner | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-09-21 |
| 1376156562 | Monica Fajobi | Nurse Practitioner | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-08-26 |
| 1174135586 | Robert Achram | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-08-18 |
| 1336751932 | Michel Attieh | Pathology | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-08-17 |
| 1346851417 | Tatiana Tvrdik | Pathology | 1364 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-08-12 |
| 1710596333 | Juna Victoria Konomi Johnson | Anesthesiologist Assistant | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2020-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716774 | Shannon Busby Bagga | Dietitian, Registered | 1806 Dekalb Ave Ne, Atlanta, GA 30307 | 2020-10-06 |
| 1366062846 | Key Counseling Group, LLC | Social Worker | 675 Seminole Ave. Ne, Ste. 111, Atlanta, GA 30307 | 2020-04-24 |
| 1730683749 | Kristina Joy Betz | Pediatrics | 2105 Uppergate Drive, Atlanta, GA 30307 | 2018-03-23 |
| 1336658558 | Erin Asteghene | Specialist/Technologist | 1509 South Ponce De Leon Ave., Atlanta, GA 30307 | 2017-09-20 |
| 1689196446 | Sera Kim | Student in an Organized Health Care Education/Training Program | 1648 Pierce Drive Ne, Atlanta, GA 30307 | 2017-07-13 |
| 1164974168 | Megan Elizabeth Tarshis | Social Worker | 675 Seminole Ave., Suite 210, Atlanta, GA 30307 | 2016-10-26 |
| 1255703880 | Jennifer Browning Eastman | Speech-Language Pathologist | 1053 Oakdale Road, Atlanta, GA 30307 | 2015-10-22 |
| 1639566714 | Amit Shah | Student in an Organized Health Care Education/Training Program | 1648 Pierce Drive, Atlanta, GA 30307 | 2015-04-16 |
| 1134524853 | Sheryl Cababat Caberto | Internal Medicine | 1648 Pierce Dr Ne, Atlanta, GA 30307 | 2014-10-23 |
| 1942568803 | Sarah Coyle Burke | Anesthesiology | 870 Inman Village Pkwy Ne, #305, Atlanta, GA 30307 | 2012-04-30 |
| Find all providers in zip 30307 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407752 | Neighbormd of Atlanta LLC | Internal Medicine | 285 Boulevard Ne Ste 435&436, Atlanta, GA 30312-4205 | 2020-11-06 |
| 1053912907 | Neighbormd of North Atlanta LLC | Internal Medicine | 1800 Peachtree St Nw Ste 730nw, Atlanta, GA 30309-2519 | 2020-11-06 |
| 1285235036 | Neighbormd of South Atlanta LLC | Internal Medicine | 3885 Princeton Lakes Way Sw Ste 412, Atlanta, GA 30331-5599 | 2020-11-06 |
| 1679137657 | Internal Medicine Consulting Services | Internal Medicine | 3365 Piedmont Rd Ne Ste 1400, Atlanta, GA 30305-1795 | 2019-04-25 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1326527144 | Vergena Montgomery Clark | Internal Medicine | 3142 Esplanade Cir Sw, Atlanta, GA 30311-4221 | 2018-08-13 |
| 1790299071 | Jay Leonard Lichtenfeld | Internal Medicine | 1711 E Clifton Rd Ne, Atlanta, GA 30307-1247 | 2017-11-26 |
| 1558872432 | Qcpi-villagemd, PC | Internal Medicine | 3445 Peachtree Rd Ne Ste 1200, Atlanta, GA 30326-3251 | 2017-10-18 |
| 1033640115 | Christopher Massad | Internal Medicine | 1364 Clifton Rd Ne Ste H-153, Atlanta, GA 30322-1059 | 2017-03-21 |
| 1114377025 | Atlanta Clinical Research Centers LLC | Internal Medicine | 5673 Peachtree Dunwoody Rd Ste 440, Atlanta, GA 30342-1797 | 2016-06-21 |
| Find all providers in ATLANTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.