MEDICARE: RODNEY M STALHEIM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	23440	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	79136	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1093762395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNEY M STALHEIM M.D.

Provider Business Mailing Address
First Line	:	PO BOX 710
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-0710
Country	:	US
Telephone Number	:	828-757-5070
Fax Number	:	828-757-5939

Provider Business Practice Location Address
First Line	:	322 MULBERRY ST SW
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-5703
Country	:	US
Telephone Number	:	828-757-6400
Fax Number	:	828-757-6424

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	02/02/2010

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