Provider Demographics
NPI:1982664678
Name:HSIEH, STEPHEN S (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:S
Last Name:HSIEH
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 1:104 W MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-6773
Mailing Address - Country:US
Mailing Address - Phone:336-224-0931
Mailing Address - Fax:336-224-0932
Practice Address - Street 1:104 W MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-6773
Practice Address - Country:US
Practice Address - Phone:336-224-0931
Practice Address - Fax:336-224-0932
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700075207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891188AMedicaid
NC2344475Medicare ID - Type UnspecifiedGROUP MCR PROVIDER ID
NC96866Medicare UPIN