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General NPI Number Information
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NPI Number | 1699700674
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Entity Type | Individual
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Provider Name | STACEY B BEAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 1512 E FRANKLIN ST STE 100
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City | CHAPEL HILL
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State | NC
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Zip | 27514-2816
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Country | US
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Telephone | 919-240-7269
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Fax | 919-240-7816
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Provider Business Mailing Address
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Address Line | 10900 WORLD TRADE BLVD
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City | RALEIGH
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State | NC
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Zip | 27617-4202
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Country | US
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Telephone | 919-237-1337
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Fax | 919-223-7162
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2014-02262
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License Number State | NC
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