MEDICARE: STEPHEN COARSEY

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	207V00000X	Obstetrics & Gynecology Physician	28478	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	026F6	OTHER	NC	BCBSNC

General Provider Information

NPI Number	:	1205815222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN COARSEY

Provider Business Mailing Address
First Line	:	PO BOX 16533
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-6533
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 FERN CREEK DR
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28625-9376
Country	:	US
Telephone Number	:	704-872-7294
Fax Number	:

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	05/12/2020

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Directions to “ STEPHEN COARSEY ” Practice Location

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