Provider Demographics
NPI:1912250499
Name:SHEARER, STEFFANY BROOKE (DO)
Entity type:Individual
Prefix:DR
First Name:STEFFANY
Middle Name:BROOKE
Last Name:SHEARER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:800 SPRINGFIELD COMMONS DR STE 115
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-8533
Mailing Address - Country:US
Mailing Address - Phone:919-876-3656
Mailing Address - Fax:919-876-2351
Practice Address - Street 1:800 SPRINGFIELD COMMONS DR STE 115
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-8533
Practice Address - Country:US
Practice Address - Phone:919-876-3656
Practice Address - Fax:919-876-2351
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-20
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS11886207N00000X
TXN7752207N00000X
OK5340207N00000X
NC201700793207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology