Provider Demographics
NPI:1104911155
Name:STEGBAUER, SCOTT A (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:STEGBAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:701 DOCTORS DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-1589
Mailing Address - Country:US
Mailing Address - Phone:252-522-4446
Mailing Address - Fax:252-522-4484
Practice Address - Street 1:701 DOCTORS DR
Practice Address - Street 2:SUITE G
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-1589
Practice Address - Country:US
Practice Address - Phone:252-522-4446
Practice Address - Fax:252-522-4484
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200700995207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1461UOtherBCBS
NC5907213Medicaid
NC5907213Medicaid
NC2075691AMedicare PIN