Healthcare Provider Details

I. General information

NPI: 1972869766
Provider Name (Legal Business Name): STEPHEN BYRON PERRY HUFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4420 LAKE BOONE TRL STE 102
RALEIGH NC
27607-7505
US

IV. Provider business mailing address

4420 LAKE BOONE TRL STE 102
RALEIGH NC
27607-7505
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-3018
  • Fax:
Mailing address:
  • Phone: 919-784-3018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number2017-00630
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: