Healthcare Provider Details

I. General information

NPI: 1730126335
Provider Name (Legal Business Name): JAMES R STEVENS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 NW CARY PKWY STE 110
CARY NC
27513-8446
US

IV. Provider business mailing address

3700 NW CARY PKWY STE 110
CARY NC
27513-8446
US

V. Phone/Fax

Practice location:
  • Phone: 919-238-2000
  • Fax:
Mailing address:
  • Phone: 919-238-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39104
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number39104
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: