Provider Demographics
NPI:1659345908
Name:STEPHENSON, SHARON ROSE (MD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ROSE
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 NEW WAVERLY PLACE
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511
Mailing Address - Country:US
Mailing Address - Phone:919-467-5941
Mailing Address - Fax:919-655-0532
Practice Address - Street 1:550 NEW WAVERLY PLACE
Practice Address - Street 2:CARY OB GYN
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-467-5941
Practice Address - Fax:919-655-0532
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32581207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7979733Medicaid
NC7979733Medicaid
210688AMedicare ID - Type Unspecified