Provider Demographics
NPI:1750560504
Name:STMD LLC
Entity type:Organization
Organization Name:STMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:TRIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-384-1400
Mailing Address - Street 1:59 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-3544
Mailing Address - Country:US
Mailing Address - Phone:828-384-1400
Mailing Address - Fax:
Practice Address - Street 1:59 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-3544
Practice Address - Country:US
Practice Address - Phone:828-384-1400
Practice Address - Fax:828-883-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherTAX ID
NC=========OtherTAX ID