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Individual

STEPHEN ALAN BAGG

Active
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Individual

STEPHEN ALAN BAGG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
200901462
NC
2085R0202X
Diagnostic Radiology Physician
Primary
LL29784
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
297841
SC
01
P01200056
RR MEDICARE SC
SC
Enumeration date
06/27/2007
Last updated
02/13/2014
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