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Individual

PHILIP EDWARD STACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
26 WESTCARE DRIVE, SUITE 302, SYLVA, NC 28779-5278
(828) 586-9200
(828) 586-7459
Mailing address
26 WESTCARE DRIVE, SUITE 302, SYLVA, NC 28779-5278
(828) 586-9200
(828) 586-7459

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
9400644
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
79118
BLUE CROSS BLUE SHEILD
NC
05
8979118
NC
Enumeration date
10/04/2006
Last updated
09/11/2023
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