Provider Demographics
NPI:1629271440
Name:STEPHENS, CAROLINE DOVE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:DOVE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2550 COURT DR STE 201
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2152
Mailing Address - Country:US
Mailing Address - Phone:704-867-1402
Mailing Address - Fax:704-671-2661
Practice Address - Street 1:2290 REMOUNT RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4725
Practice Address - Country:US
Practice Address - Phone:704-867-1402
Practice Address - Fax:888-720-2814
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-00697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1629271440Medicaid
NC5907066Medicaid