Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Miss. Stephanie Marie Bullock, CSA

Individual provider Surgical Assistant · NPI 1871049510

Miss. Stephanie Marie Bullock, CSA is an Undefined Non-Physician Type (Specify) in Hiram, Georgia. Graduated from Eastern Virginia Medical School in 2016, 10 years ago. Works from 2 locations.

Years since qualifying
10
Trained at
Eastern Virginia Medical School
In the registry since
2016

Practice location Address checks out

277 Covington Dr
Hiram, GA 30141-2257
Phone: (757) 287-8914
Fax: (844) 550-4221
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3595 Hiram Douglasville Hwy Ste 238, Hiram, GA 30141-4965 — (757) 287-8914

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X

Record details

NPI number1871049510
Entity typeIndividual (Type 1)
GenderFemale
Credentials CSA
Sole proprietorNo
NPI enumeratedSeptember 1, 2016
Last updated in NPPESDecember 18, 2025
Certification dateDecember 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolEASTERN VIRGINIA MEDICAL SCHOOL
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Hiram