Basic Information
Provider Information
NPI: 1437562600
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEADMAN
FirstName: RICHARD
MiddleName: ANDERSON
NamePrefix:  
NameSuffix: III
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 751649
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282751649
CountryCode: US
TelephoneNumber: 8437891620
FaxNumber: 8437242440
Practice Location
Address1: 2085 HENRY TECKLENBURG DR STE 310
Address2:  
City: CHARLESTON
State: SC
PostalCode: 294147713
CountryCode: US
TelephoneNumber: 8432665500
FaxNumber: 8436068007
Other Information
ProviderEnumerationDate: 06/05/2014
LastUpdateDate: 07/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XLL37028SCN Allopathic & Osteopathic PhysiciansSurgery 
208600000X37028SCY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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