MEDICARE: DR. STEPHEN MITCHELL HERRING MD DDS

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	208200000X	Plastic Surgery Physician	35368	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

General Provider Information

NPI Number	:	1255498887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN MITCHELL HERRING MD DDS

Provider Business Mailing Address
First Line	:	PO BOX 53726
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28305-3726
Country	:	US
Telephone Number	:	910-486-9093
Fax Number	:	910-486-9048

Provider Business Practice Location Address
First Line	:	516 BEAUMONT RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4443
Country	:	US
Telephone Number	:	910-486-9093
Fax Number	:	910-486-9048

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

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/08/2007

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