Healthcare Provider Details

I. General information

NPI: 1780067207
Provider Name (Legal Business Name): PURE CARDIOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 WAXHAW PROFESSIONAL PARK DR STE C-500
WAXHAW NC
28173-5024
US

IV. Provider business mailing address

1731 FUNNY CIDE DR
WAXHAW NC
28173-8294
US

V. Phone/Fax

Practice location:
  • Phone: 704-233-7449
  • Fax: 980-322-0647
Mailing address:
  • Phone: 704-233-7449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number200300531
License Number StateNC

VIII. Authorized Official

Name: DR. CHRISTOPHER GEORGE STEPHENSON
Title or Position: OWNER
Credential: MD
Phone: 704-233-7449