Individual
STEPHANIE D. MYRACLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
89 HOSPITAL DR STE A-UP1, BREVARD, NC 28712-4837
(828) 570-5505
(828) 259-2581
Mailing address
89 HOSPITAL DR STE A-UP1, BREVARD, NC 28712-4837
(828) 570-5505
(828) 259-2581
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2007-01974
NC
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
2007-01974
NC
207NS0135X
Procedural Dermatology Physician
2007-01974
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5918699
—
NC
Enumeration date
06/07/2007
Last updated
01/30/2025
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