Provider Demographics
NPI:1396727251
Name:AVITABILE, STEVEN R (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:AVITABILE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BEAR CAT WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6619
Mailing Address - Country:US
Mailing Address - Phone:919-532-1000
Mailing Address - Fax:919-532-1600
Practice Address - Street 1:1000 BEAR CAT WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-6619
Practice Address - Country:US
Practice Address - Phone:919-532-1000
Practice Address - Fax:919-532-1600
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3233111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0859AOtherBCBS NC
NC0859AOtherBCBS NC