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NPI Code Detail

MEDICARE: WENDY J STOUT MD

MEDICARE:   WENDY J STOUT  MD
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
1207P00000XEmergency Medicine PhysicianNC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2130U0OTHERNCBCBS

General Provider Information

NPI Number : 1982664629
Entity Type Code : Individual
Provider Name (Legal Business Name) : WENDY J STOUT MD
Provider Business Mailing Address
First Line : PO BOX 60445
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0445
Country : US
Telephone Number : 843-237-3378
Fax Number : 843-237-5073
Provider Business Practice Location Address
First Line : 321 MULBERRY ST SW
Second Line :
City : LENOIR
State : NC
Zip : 28645-5720
Country : US
Telephone Number : 843-237-3378
Fax Number : 843-237-5073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2006
Last Update Date : 12/14/2007

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Directions to “ WENDY J STOUT MD” Practice Location

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