Provider Demographics
NPI:1790953644
Name:LANUTI, STEPHEN LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LOUIS
Last Name:LANUTI
Suffix:
Gender:M
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5501
Practice Address - Country:US
Practice Address - Phone:910-277-9164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96006022086H0002X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086H0002XAllopathic & Osteopathic PhysiciansSurgeryHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1409023OtherUNITED HEALTH CARE
NC1790953644Medicaid
NC50930OtherBCBS
SCN00602OtherSC MEDICAID
NC020032864OtherRAILROAD MEDICARE
NC8950930Medicaid
NC1409023OtherUNITED HEALTH CARE
NC50930OtherBCBS
NCNC8640AMedicare PIN
NC1790953644Medicaid