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General NPI Number Information
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NPI Number | 1376963975
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Entity Type | Individual
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Provider Name | STEPHANE SIA
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Gender | Male
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 8707 COMMERCE DR
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City | EASTON
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State | MD
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Zip | 21601-6910
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Country | US
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Telephone | 443-239-2033
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Fax | 855-461-3481
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Provider Business Mailing Address
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Address Line | 590 NAAMANS RD
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City | CLAYMONT
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State | DE
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Zip | 19703-2308
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Country | US
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Telephone | 302-553-3259
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Fax | 302-385-2080
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AC002929
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | L8-0000215
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | LG-0000724
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License Number State | DE
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AC002929
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | L8-0000215
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License Number State | DE
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AC001189
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License Number State | MD
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