Basic Information
| Provider Information | |||||||||
| NPI: | 1073611091 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NORTH | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | WILLIAM | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 602373 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282602373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282131500 | ||||||||
| FaxNumber: | 8286516570 | ||||||||
| Practice Location | |||||||||
| Address1: | 11728 S 226 HWY | ||||||||
| Address2: | |||||||||
| City: | SPRUCE PINE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287778954 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287655672 | ||||||||
| FaxNumber: | 8287655676 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 08/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0000X | 2006-00475 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | Adolescent Medicine | 207QA0401X | 326033 | LA | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207QA0401X | 286296 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207QA0401X | 223824 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207QA0401X | 35.140995 | OH | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207QA0401X | T9199 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207QA0401X | MD61123191 | WA | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207QA0401X | 206-00475 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | Addiction Medicine | 207Q00000X | 2006-00475 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8907673 | 01 | NC | MEDCAID PHYSICIAN | OTHER | 235013 | 01 | NC | MEDICARE PHYSICIAN | OTHER | 014MX | 01 | NC | BCBS LABS | OTHER | 07673 | 01 | NC | BCBS PHYSICIAN | OTHER | 34U011 | 01 | NC | MEDICARE SWINGBED | OTHER | 235013B | 01 | NC | MEDICARE PHYSICIAN | OTHER | 00513 | 01 | NC | BCBS | OTHER | 3400011 | 01 | NC | MEDCAID | OTHER | 411013849 | 01 | NC | MEDICARE RAILROAD | OTHER | 0081P | 01 | NC | BCBS SWINGBED | OTHER |