Individual
CASSIE STECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
200 HAWTHORNE LANE, CHARLOTTE, NC 28204-2515
(704) 834-4000
Mailing address
200 PROVIDENCE RD., STE. 101, CHARLOTTE, NC 28207-1347
(704) 749-5800
(704) 749-5819
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-02625
NC
363A00000X
Physician Assistant
10001039A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000593406
ANTHEM PROVIDER NUMBER
IN
05
—
PENDING
—
IN
Enumeration date
10/01/2008
Last updated
04/26/2012
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