Provider Demographics
NPI:1700826435
Name:STAFFORD, STEPHEN J (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:STAFFORD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:160 MACGREGOR PINES DRIVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6040
Mailing Address - Country:US
Mailing Address - Phone:919-873-9300
Mailing Address - Fax:919-859-1729
Practice Address - Street 1:3320 WAKE FOREST RD
Practice Address - Street 2:SUITE 320
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7300
Practice Address - Country:US
Practice Address - Phone:919-790-5500
Practice Address - Fax:919-790-0108
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2008-11-18
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Provider Licenses
StateLicense IDTaxonomies
NC26056208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC86570Medicare UPIN