Anthony Stallion, MD | |
100 Medical Park Dr, Suite 310, Concord, NC 28025-2966 | |
(704) 403-2662 | |
(704) 403-2670 |
Full Name | Anthony Stallion |
---|---|
Gender | Male |
Speciality | Surgery - Pediatric Surgery |
Location | 100 Medical Park Dr, Concord, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265499206 | NPI | - | NPPES |
0803198 | Medicaid | OH | |
1265499206 | Medicaid | NC | |
Q0154E | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0120X | Surgery - Pediatric Surgery | 35060022S (Ohio) | Secondary |
2086S0120X | Surgery - Pediatric Surgery | 2013-01542 (North Carolina) | Primary |
Entity Name | Beaumont Medical Group- Specialty Services |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578072906 PECOS PAC ID: 7214299866 Enrollment ID: O20180320002549 |
Mailing Address | Practice Location Address |
---|---|
Anthony Stallion, MD Po Box 601888, Charlotte, NC 28260-1888 Ph: (704) 403-2662 | Anthony Stallion, MD 100 Medical Park Dr, Suite 310, Concord, NC 28025-2966 Ph: (704) 403-2662 |
Jacqueline Tracey, Surgery Medicare: Accepting Medicare Assignments Practice Location: 200 Medical Park Dr, Suite 430, Concord, NC 28025 Phone: 704-403-7070 | |
Medhat William Takla, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 200 Medical Park Dr, Ste 230, Concord, NC 28025 Phone: 704-403-1349 | |
Matthew David Fox, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 200 Medical Park Dr, Ste 430, Concord, NC 28025 Phone: 704-403-7070 | |
Laura Elizabeth Hudson, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 200 Medical Park Dr Ste 400, Concord, NC 28025 Phone: 704-786-1108 Fax: 704-782-1826 | |
Jennifer Brooke Hale, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-403-1311 | |
Michael Joseph Beckman, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 200 Medical Park Dr, Ste 430, Concord, NC 28025 Phone: 704-403-5890 |