MEDICARE: DR. STEPHEN M SALEEBY DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1501	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08765	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1134102155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN M SALEEBY DC

Provider Business Mailing Address
First Line	:	3814 BROWNING PL
Second Line	:	SUITE 102
City	:	RALEIGH
State	:	NC
Zip	:	27609-7166
Country	:	US
Telephone Number	:	919-782-4733
Fax Number	:	919-783-8225

Provider Business Practice Location Address
First Line	:	3814 BROWNING PL
Second Line	:	SUITE 102
City	:	RALEIGH
State	:	NC
Zip	:	27609-7166
Country	:	US
Telephone Number	:	919-782-4733
Fax Number	:	919-783-8225

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	01/21/2010

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