Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 9801022 | NC |
Y | 111NI0900X | Internist | 9801022 | NC |
N | 207RG0300X | Geriatric Medicine | 9801022 | NC |
NPI | 1013958651 |
---|---|
Provider Name | Dr. Stephen H Powell |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28210-3271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 14/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
891171X | (05) | NC |
C01522 | (02) | NC |
N01023 | (05) | SC |