Provider Demographics
NPI:1063490910
Name:HESS, STEVEN PAUL (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:HESS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 POWELL MILL RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-1531
Mailing Address - Country:US
Mailing Address - Phone:864-574-0070
Mailing Address - Fax:864-574-0882
Practice Address - Street 1:105 POWELL MILL RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-1531
Practice Address - Country:US
Practice Address - Phone:864-574-0070
Practice Address - Fax:864-574-0882
Is Sole Proprietor?:No
Enumeration Date:2006-01-02
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC00494207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC004943Medicaid
990009268OtherRR MCR
990009268OtherRR MCR
SC004943Medicaid