MEDICARE: DR. STEVE ELEFTHERIS VACALIS D.O.

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	207Q00000X	Family Medicine Physician	9901066	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871580399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVE ELEFTHERIS VACALIS D.O.

Provider Business Mailing Address
First Line	:	2711 X RAY DR
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-7491
Country	:	US
Telephone Number	:	704-834-2420
Fax Number	:	704-834-2426

Provider Business Practice Location Address
First Line	:	2711 X RAY DR
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-7491
Country	:	US
Telephone Number	:	704-834-2420
Fax Number	:	704-834-2426

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	07/18/2011

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Directions to “ DR. STEVE ELEFTHERIS VACALIS D.O.” Practice Location

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