Individual
DR. JOSEPH ANTHONY DESTEFANO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
840 W FLOYD BAKER BLVD, GAFFNEY, SC 29341-1845
(864) 489-3300
(864) 488-3744
Mailing address
PO BOX 277723, ATLANTA, GA 30384-7723
(864) 560-4123
(864) 560-4023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82516
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
825165
—
SC
01
—
SCH7836067
MEDICARE PIN
SC
01
—
SCH7836084
MEDICARE PIN
SC
01
—
SCH783J577
MEDICARE PIN
SC
Enumeration date
05/21/2019
Last updated
08/15/2023
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