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Individual

WENDY J STOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
321 MULBERRY ST SW, LENOIR, NC 28645-5720
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 60445, CHARLOTTE, NC 28260-0445
(843) 237-3378
(843) 237-5073

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
130U0
BCBS
NC
05
89130U0
NC
Enumeration date
03/25/2006
Last updated
12/14/2007
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