Provider Demographics
NPI:1205516382
Name:STEVENSON, PAUL MORGAN (PA-C)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:MORGAN
Last Name:STEVENSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 PARCHMENT CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8673
Mailing Address - Country:US
Mailing Address - Phone:919-219-4635
Mailing Address - Fax:
Practice Address - Street 1:20280 MARKET ST
Practice Address - Street 2:
Practice Address - City:ONANCOCK
Practice Address - State:VA
Practice Address - Zip Code:23417-1331
Practice Address - Country:US
Practice Address - Phone:757-695-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant