Provider Demographics
NPI:1821582479
Name:STEPHENS, MATTHEW CHRISTOPHER (PA-C)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:CHRISTOPHER
Last Name:STEPHENS
Suffix:
Gender:
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 1:2601 N ELM ST STE A
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3063
Mailing Address - Country:US
Mailing Address - Phone:910-236-2200
Mailing Address - Fax:910-370-0488
Practice Address - Street 1:2601 N ELM ST STE A
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3063
Practice Address - Country:US
Practice Address - Phone:910-236-2200
Practice Address - Fax:910-370-0488
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07867363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant