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General NPI Number Information
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NPI Number | 1710085782
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Entity Type | Individual
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Provider Name | MICHAEL SHANE STALVEY MD
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Gender | Male
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | MEDICAL CENTER BLVD
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City | WINSTON SALEM
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State | NC
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Zip | 27157-1711
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Country | US
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Telephone | 336-713-4500
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Fax | 336-713-4501
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Provider Business Mailing Address
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Address Line | 2725 4TH AVE S UNIT 4E
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City | BIRMINGHAM
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State | AL
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Zip | 35233-2734
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Country | US
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Telephone | 205-915-5626
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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 | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 2021-02006
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License Number State | NC
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