Healthcare Provider Details

I. General information

NPI: 1376814368
Provider Name (Legal Business Name): STELOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2012
Last Update Date: 01/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 ATLANTIC AVE
RALEIGH NC
27604-1502
US

IV. Provider business mailing address

2600 ATLANTIC AVE
RALEIGH NC
27604-1502
US

V. Phone/Fax

Practice location:
  • Phone: 919-881-9999
  • Fax: 919-719-8601
Mailing address:
  • Phone: 919-881-9999
  • Fax: 919-719-8601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HIRENDRA N DOSHI
Title or Position: PARTNER
Credential: MD
Phone: 919-881-9999