Individual
DR. JOHN S STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3030 LATROBE DR, CHARLOTTE RADIOLOGY, CHARLOTTE, NC 28211-4866
(704) 362-1945
(704) 770-0501
Mailing address
3030 LATROBE DR, CHARLOTTE RADIOLOGY, CHARLOTTE, NC 28211-4866
(704) 362-1945
(704) 770-0501
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
15587
NC
2085R0202X
Diagnostic Radiology Physician
Primary
15587
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194461
—
SC
01
—
300080139
RAILROAD MEDICARE
—
05
—
8979782
—
NC
Enumeration date
09/02/2005
Last updated
01/20/2010
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