Healthcare Provider Details

I. General information

NPI: 1255741757
Provider Name (Legal Business Name): STEPHEN JAMES ACOSTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2014
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4220
US

IV. Provider business mailing address

1428 LILY ESTATES DR
RALEIGH NC
27614-6003
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-7890
  • Fax:
Mailing address:
  • Phone: 407-791-8365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2018-01837
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number2018-01837
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: