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NPI Code Detail

MEDICARE: MR. STEPHEN MICHAEL DELELLIS PA-C

MEDICARE: MR. STEPHEN MICHAEL DELELLIS 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
1363A00000XPhysician Assistant103216NC

General Provider Information

NPI Number : 1366652125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN MICHAEL DELELLIS PA-C
Provider Business Mailing Address
First Line : 136 TIMBERLAKE DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28314-1240
Country : US
Telephone Number : 910-643-0729
Fax Number : 910-643-1113
Provider Business Practice Location Address
First Line : 3622 N MAIN ST
Second Line :
City : HOPE MILLS
State : NC
Zip : 28348-1937
Country : US
Telephone Number : 910-423-7771
Fax Number : 910-423-4177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 06/10/2024

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Directions to “ MR. STEPHEN MICHAEL DELELLIS PA-C” Practice Location

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