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NPI Code Detail

MEDICARE: MR. CHRISTOPHER C STEPHANOFF PA

MEDICARE:  MR. CHRISTOPHER C STEPHANOFF  PA
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
1363AM0700XMedical Physician AssistantA341HEMSC

General Provider Information

NPI Number : 1265442891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER C STEPHANOFF PA
Provider Business Mailing Address
First Line : 2910 TRICOM ST
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9350
Country : US
Telephone Number : 843-572-9211
Fax Number : 843-572-0457
Provider Business Practice Location Address
First Line : 2910 TRICOM ST
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9350
Country : US
Telephone Number : 843-572-9211
Fax Number : 843-572-0457
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 07/08/2007

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Directions to “ MR. CHRISTOPHER C STEPHANOFF PA” Practice Location

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