Provider Demographics
NPI:1336126572
Name:CHAMBERLAIN, STEVEN A (MD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:A
Last Name:CHAMBERLAIN
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 601884
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1884
Mailing Address - Country:US
Mailing Address - Phone:980-487-2800
Mailing Address - Fax:704-487-0186
Practice Address - Street 1:110 W GROVER ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3825
Practice Address - Country:US
Practice Address - Phone:980-487-2800
Practice Address - Fax:704-487-0186
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28477207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
21889OtherBCBS
21989OtherMEDCOST
2036101OtherAETNA US HEALTH
NC8921889Medicaid
NC1336126572Medicaid
4299208OtherAETNA
SCN28477Medicaid
560943383BOtherCIGNA
741490OtherUHC
160021404OtherRAILROAD MEDICARE
291784OtherMAMSI
AC2917356OtherDEA
291784OtherMAMSI
21889OtherBCBS
D26873Medicare UPIN
SCN28477Medicaid