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General NPI Number Information
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NPI Number | 1003000936
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Entity Type | Individual
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Provider Name | MARK A STELLINGWORTH MD
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Gender | Male
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 701 MEDICAL PARK DR STE 301
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City | HARTSVILLE
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State | SC
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Zip | 29550-4779
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Country | US
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Telephone | 843-383-5978
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Fax | 843-383-5977
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Provider Business Mailing Address
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Address Line | PO BOX 743904
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City | ATLANTA
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State | GA
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Zip | 30374-3904
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Country | US
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Telephone | 803-296-7320
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Fax | 803-296-7330
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | 36377
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 024969
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 36377
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License Number State | SC
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