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General NPI Number Information
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NPI Number | 1255330098
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Entity Type | Individual
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Provider Name | STEPHEN P HINMAN PA
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Gender | Male
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 5701 W FRIENDLY AVE
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City | GREENSBORO
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State | NC
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Zip | 27410-4112
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Country | US
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Telephone | 336-852-1915
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Fax |
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Provider Business Mailing Address
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Address Line | 50 LEROY ST
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City | POTSDAM
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State | NY
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Zip | 13676-1786
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Country | US
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Telephone | 315-265-3300
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-12252
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 003599
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License Number State | NY
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