Wentworth, Stacy

Wentworth, Stacy is an sole proprietor health care provider with primary practice located at 501 N. Elam Avenue , Greensboro NC 27403. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Wentworth, Stacy can be contacted via phone (336) 832-1100.

Contact Information

Primary practice address
501 N. Elam Avenue Greensboro NC 27403
Phone: (336) 832-1100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 2007-00580 North Carolina
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 200700580 North Carolina

Profile Details

NPI number 1073792974
LBN Legal business name Wentworth, Stacy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 26th, 2007
Last updated Aug 10th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073792974 NPPES
Virginia MEDICAID 1073792974
Virginia Other P00838358
Virginia MEDICAID 5912234

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