Provider Demographics
NPI:1386637338
Name:FOX, STEPHEN CARY (MD, FACP)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:CARY
Last Name:FOX
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1610
Mailing Address - Country:US
Mailing Address - Phone:610-647-2747
Mailing Address - Fax:610-640-3870
Practice Address - Street 1:21 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1610
Practice Address - Country:US
Practice Address - Phone:610-647-2747
Practice Address - Fax:610-640-3870
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020224E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAD71418Medicare UPIN