Individual
STEPHEN R CIRELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
851 LOCUST ST, ROGERSVILLE, TN 37857-2407
(423) 272-2671
(423) 272-7667
Mailing address
999 EXECUTIVE PARK BLVD, SUITE 201, KINGSPORT, TN 37660-4632
(423) 224-3250
(423) 224-3258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200201566
NC
207R00000X
Internal Medicine Physician
Primary
40343
TN
208M00000X
Hospitalist Physician
40343
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13230
BCBS INDIVIDUAL PROVIDER
NC
05
—
3810012222
—
WV
05
—
7100053310
—
KY
05
—
8913230
—
NC
Enumeration date
08/04/2005
Last updated
08/06/2012
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