Individual
JOSEPH ANTHONY DESTEFANO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 N JUSTICE ST, HENDERSONVILLE, NC 28791-3410
(828) 694-7687
(828) 694-5763
Mailing address
432 ARROWHEAD DR, 3RD FLOOR, KINGSPORT, TN 37664-5291
(423) 557-2231
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101251249
VA
207R00000X
Internal Medicine Physician
17274
SC
207R00000X
Internal Medicine Physician
Primary
2003-00332
NC
207R00000X
Internal Medicine Physician
38537
TN
208M00000X
Hospitalist Physician
38537
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508841032
—
NC
05
—
1508841032
—
VA
05
—
230214777B
—
GA
05
—
230214777C
—
GA
05
—
3892268
—
TN
05
—
GP3988
—
SC
01
—
NC5448C
MEDICARE PTAN
NC
Enumeration date
12/07/2005
Last updated
04/10/2025
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