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General NPI Number Information
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NPI Number | 1922197136
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Entity Type | Individual
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Provider Name | STEPHEN BURNEY BRIDGERS MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 9858 N. W.R. LATHAN STREET
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City | CLARKTON
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State | NC
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Zip | 28433-0095
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Country | US
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Telephone | 910-647-1503
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Fax | 910-647-1505
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Provider Business Mailing Address
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Address Line | 5221 PARAMOUNT PKWY STE 220
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City | MORRISVILLE
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State | NC
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Zip | 27560-5490
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Country | US
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Telephone | 984-215-4110
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30542
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License Number State | NC
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