Healthcare Provider Details

I. General information

NPI: 1477949915
Provider Name (Legal Business Name): HOPE MORGAN STATON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2015
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 LAKE CONCORD RD NE
CONCORD NC
28025-3057
US

IV. Provider business mailing address

66 LAKE CONCORD RD NE
CONCORD NC
28025-3057
US

V. Phone/Fax

Practice location:
  • Phone: 704-403-7720
  • Fax: 704-403-7730
Mailing address:
  • Phone: 704-403-7720
  • Fax: 704-403-7730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2018-00563
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: