Provider Demographics
NPI:1124019518
Name:HUBER, STEPHEN CARY (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CARY
Last Name:HUBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-7020
Mailing Address - Fax:843-664-9545
Practice Address - Street 1:101 S RAVENEL ST
Practice Address - Street 2:SUITE 270
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2644
Practice Address - Country:US
Practice Address - Phone:843-777-7020
Practice Address - Fax:843-664-9545
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36179208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC361799Medicaid
SCSC14218552OtherMEDICARE PTAN