Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 2016-01108 | NC |
Y | 111NI0900X | Internist | 2016-01108 | NC |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 2016-01108 | NC |
NPI | 1013216282 |
---|---|
Provider Name | Stephen Tyler Abbott |
First Address | Durham, NC 27707-8127 |
Second Address | Sanford, NC 27330-4162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2011 |
Last Update Date | 19/05/2017 |