1073611091 NPI number — STEPHEN WILLIAM NORTH M.D.

Table of content: STEPHEN WILLIAM NORTH M.D. (NPI 1073611091)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073611091 NPI number — STEPHEN WILLIAM NORTH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NORTH
Provider First Name:
STEPHEN
Provider Middle Name:
WILLIAM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073611091
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 602373
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28260-2373
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-213-1500
Provider Business Mailing Address Fax Number:
828-651-6570

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11728 S 226 HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRUCE PINE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28777-8954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-765-5672
Provider Business Practice Location Address Fax Number:
828-765-5676
Provider Enumeration Date:
09/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207QA0000X , with the licence number:  2006-00475 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: 326033 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: 286296 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: 223824 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: 35.140995 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: T9199 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: MD61123191 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: 206-00475 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 2006-00475 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8907673 . This is a "MEDCAID PHYSICIAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 235013 . This is a "MEDICARE PHYSICIAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 014MX . This is a "BCBS LABS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 07673 . This is a "BCBS PHYSICIAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 34U011 . This is a "MEDICARE SWINGBED" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 235013B . This is a "MEDICARE PHYSICIAN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 00513 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 3400011 . This is a "MEDCAID" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 411013849 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0081P . This is a "BCBS SWINGBED" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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