Provider Demographics
NPI:1619993037
Name:SITTLER, STEPHANIE CATE (MD)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CATE
Last Name:SITTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ANN
Other - Last Name:CATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 EAST STATESVILLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115
Mailing Address - Country:US
Mailing Address - Phone:704-663-1992
Mailing Address - Fax:704-663-2073
Practice Address - Street 1:400 EAST STATESVILLE AVENUE
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115
Practice Address - Country:US
Practice Address - Phone:704-663-1992
Practice Address - Fax:704-663-2073
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0099-01613207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC126YFOtherNCBCBS
NC89126YFMedicaid
NC126YFOtherNCBCBS
NC2281110Medicare ID - Type Unspecified