Healthcare Provider Details

I. General information

NPI: 1801893524
Provider Name (Legal Business Name): STEPHEN DOUGLAS CAMPBELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 N FAYETTEVILLE ST STE A
ASHEBORO NC
27203-5573
US

IV. Provider business mailing address

PO BOX 5418
ASHEBORO NC
27204-5418
US

V. Phone/Fax

Practice location:
  • Phone: 336-625-3248
  • Fax: 336-625-6629
Mailing address:
  • Phone: 336-625-2333
  • Fax: 336-625-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2008-00339
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: