Provider Demographics
NPI:1558314575
Name:FOLSTAD, STEVEN G (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:FOLSTAD
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 1:2029 COLONY PINES DR
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-6470
Mailing Address - Country:US
Mailing Address - Phone:704-617-9974
Mailing Address - Fax:
Practice Address - Street 1:206 JOE V. KNOX AVENUE
Practice Address - Street 2:SUITE H
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8104
Practice Address - Country:US
Practice Address - Phone:424-488-3467
Practice Address - Fax:704-660-1396
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34791202K00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F25402Medicare UPIN
F25402Medicare UPIN
SCN34791Medicaid
NC1030WOtherBCBSNC
NC2237400AMedicare PIN