Provider Demographics
NPI:1568755163
Name:STACY, SYLVIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIE
Middle Name:
Last Name:STACY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SYLVIE
Other - Middle Name:
Other - Last Name:BOITEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1255 GOLDEN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-4050
Mailing Address - Country:US
Mailing Address - Phone:086-482-5465
Mailing Address - Fax:888-383-6721
Practice Address - Street 1:1255 GOLDEN FOREST DR
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4050
Practice Address - Country:US
Practice Address - Phone:508-648-2546
Practice Address - Fax:888-383-6721
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4512232083P0901X
MA2617832083P0901X
IA421212083P0901X
VA01012573282083P0901X
FL1236442083P0901X
AL334102083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine