1477896942 NPI number — DEBORAH ANN STOIA PHYSICIAN ASSISTANT

Table of content: DEBORAH ANN STOIA PHYSICIAN ASSISTANT (NPI 1477896942)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477896942 NPI number — DEBORAH ANN STOIA PHYSICIAN ASSISTANT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOIA
Provider First Name:
DEBORAH
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHYSICIAN ASSISTANT
Provider Gender Code:
F

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:
1477896942
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4309 MEDICAL PARK DRIVE
Provider Second Line Business Mailing Address:
DUKE PAIN MEDICINE, ATTN: DEB STOIA
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-385-9627
Provider Business Mailing Address Fax Number:
919-613-4525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4309 MEDICAL PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27704-2388
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-681-1924
Provider Business Practice Location Address Fax Number:
919-660-9693
Provider Enumeration Date:
04/02/2013

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: 363A00000X , with the licence number:  50.000758 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 0010-05031 , 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)





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