Individual
SHELBY A STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1629 OWEN DR, FAYETTEVILLE, NC 28304-3425
(910) 484-2284
Mailing address
PO BOX 64363, FAYETTEVILLE, NC 28306-0363
(910) 483-3534
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
24950
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180018924
RAILROAD MEDICARE
NC
05
—
8979731
—
NC
05
—
8979732
—
NC
Enumeration date
04/27/2006
Last updated
08/21/2019
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