Provider Demographics
NPI:1699902619
Name:HUNT, STEPHEN W (CPO)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:W
Last Name:HUNT
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PATEWOOD DR BLDG C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3593
Mailing Address - Country:US
Mailing Address - Phone:864-454-9140
Mailing Address - Fax:864-454-9145
Practice Address - Street 1:200 PATEWOOD DR BLDG C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3593
Practice Address - Country:US
Practice Address - Phone:864-454-9140
Practice Address - Fax:864-454-9145
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1699902619Medicaid