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NPI Code Detail

MEDICARE: STEFAN SHANE ATKINSON CFO, ROA

MEDICARE: STEFAN SHANE ATKINSON CFO, ROA
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
1174400000XSpecialist

General Provider Information

NPI Number : 1639290513
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEFAN SHANE ATKINSON CFO, ROA
Provider Business Mailing Address
First Line : 314 CRUTCHFIELD ST
Second Line :
City : DURHAM
State : NC
Zip : 27704-2725
Country : US
Telephone Number : 919-471-4994
Fax Number : 919-471-4995
Provider Business Practice Location Address
First Line : 314 CRUTCHFIELD ST
Second Line :
City : DURHAM
State : NC
Zip : 27704-2725
Country : US
Telephone Number : 919-471-4994
Fax Number : 919-471-4995
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 05/04/2010

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Directions to “ STEFAN SHANE ATKINSON CFO, ROA” Practice Location

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