Provider Demographics
NPI:1881675957
Name:LIES, STEPHEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:LIES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:102 HANDLEY PARK CT
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1769
Mailing Address - Country:US
Mailing Address - Phone:919-734-3344
Mailing Address - Fax:919-735-3025
Practice Address - Street 1:102 HANDLEY PARK COURT
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1769
Practice Address - Country:US
Practice Address - Phone:919-734-3344
Practice Address - Fax:919-735-3025
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC23729207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8951917Medicaid
NC8951917Medicaid
C85150Medicare UPIN