Provider Demographics
NPI:1114994142
Name:HUBBARD, STEPEHN ADRIAN (MD,FACEP)
Entity Type:Individual
Prefix:DR
First Name:STEPEHN
Middle Name:ADRIAN
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:MD,FACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6783 ROLLING VIEW DR
Mailing Address - Street 2:
Mailing Address - City:TOBACCOVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27050-9680
Mailing Address - Country:US
Mailing Address - Phone:336-922-6038
Mailing Address - Fax:
Practice Address - Street 1:6783 ROLLING VIEW DR
Practice Address - Street 2:
Practice Address - City:TOBACCOVILLE
Practice Address - State:NC
Practice Address - Zip Code:27050-9680
Practice Address - Country:US
Practice Address - Phone:336-922-6038
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38627207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE78741Medicare UPIN