Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 9701159 | NC |
NPI | 1033480462 |
---|---|
Provider Name | Dr. Paul R Steadman |
First Address | Fort Mill, SC 29715-5814 |
Second Address | Charlotte, NC 28210-8475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2012 |
Last Update Date | 08/11/2013 |