Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 200400781 | NC |
N | 207P00000X | Emergency Physician | 35086087 | OH |
N | 207P00000X | Emergency Physician | 45310 | MN |
Y | 207P00000X | Emergency Physician | 83711 | SC |
NPI | 1003847898 |
---|---|
Provider Name | Stephanie A Taft |
First Address | Atlanta, GA 30374-3070 |
Second Address | Spartanburg, SC 29303-3040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 14/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003847898 | (05) | NC |
19CU4 | BCBS NC (01) | NC |
2546598 | (05) | OH |
34938000 | (05) | WI |
357467000 | (05) | MN |
930002841 | (02) | MN |
I16091 | (02) | OH |
Q0078W | (05) | SC |