Healthcare Provider Details

I. General information

NPI: 1538141866
Provider Name (Legal Business Name): M. MERIKATON FEAVER STELLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 HOSPITAL DR
SPRUCE PINE NC
28777-8943
US

IV. Provider business mailing address

88 HOSPITAL DR
SPRUCE PINE NC
28777-8943
US

V. Phone/Fax

Practice location:
  • Phone: 828-765-6101
  • Fax:
Mailing address:
  • Phone: 828-765-6101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200000984
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: