Provider Demographics
NPI:1740371871
Name:YOUNG, STEPHEN L (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:YOUNG
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 1:101 MANNING DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:919-966-4996
Mailing Address - Fax:
Practice Address - Street 1:211 FRIDAY CENTER DR
Practice Address - Street 2:SUITE 2057
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9499
Practice Address - Country:US
Practice Address - Phone:919-966-4996
Practice Address - Fax:919-843-6949
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0095-01469207R00000X
NC9501469207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8989741Medicaid
NC8989741Medicaid
NCE75267Medicare UPIN