MEDICARE: ERIN STOVER PA-C

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	363A00000X	Physician Assistant	0010-05207	NC

General Provider Information

NPI Number	:	1114325651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN STOVER PA-C

Provider Business Mailing Address
First Line	:	7 PROFESSIONAL DR
Second Line	:
City	:	SNOW HILL
State	:	NC
Zip	:	28580-1332
Country	:	US
Telephone Number	:	252-747-8162
Fax Number	:	252-747-8163

Provider Business Practice Location Address
First Line	:	140 SCHOOL DR
Second Line	:
City	:	SNOW HILL
State	:	NC
Zip	:	28580-7288
Country	:	US
Telephone Number	:	252-747-3814
Fax Number	:

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

Provider Enumeration Date	:	12/16/2014
Last Update Date	:	02/01/2023

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Directions to “ ERIN STOVER PA-C” Practice Location

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