Provider Demographics
NPI:1427243740
Name:BURNS, STACY J (MD)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:J
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:J
Other - Last Name:VRAGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:520 N ELAM AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1127
Mailing Address - Country:US
Mailing Address - Phone:336-547-1792
Mailing Address - Fax:336-547-1769
Practice Address - Street 1:520 N ELAM AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403
Practice Address - Country:US
Practice Address - Phone:336-547-1792
Practice Address - Fax:336-547-1769
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-01315207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1427243740Medicaid
NC19L9BOtherBCBSNC
NYJ400020529Medicare PIN
NY1427243740Medicare UPIN