Provider Demographics
NPI:1376535450
Name:ENGELKE, STEPHEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
Last Name:ENGELKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 751069
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1069
Mailing Address - Country:US
Mailing Address - Phone:252-744-3253
Mailing Address - Fax:252-744-3194
Practice Address - Street 1:CHILDREN'S HOSPITAL 227
Practice Address - Street 2:ECU PHYSICIANS PEDIATRIC NEONATOLOGY PCMH NEONATAL
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-744-0766
Practice Address - Fax:252-744-0392
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC232702080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC370015149OtherRAILROAD MEDICARE
NC8930673Medicaid
NC30673OtherBCBS NC
NCE11865Medicare UPIN
NC206150BMedicare PIN