Basic Information
| Provider Information | |||||||||
| NPI: | 1528201779 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOLEY | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | JEANINE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2605 BLUE RIDGE RD | ||||||||
| Address2: | SUITE #300 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276076475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197873448 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2605 BLUE RIDGE RD | ||||||||
| Address2: | SUITE #300 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276076475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197873448 | ||||||||
| FaxNumber: | 9192320006 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2009 | ||||||||
| LastUpdateDate: | 09/26/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2012-01828 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.