Stallworth, Acquawon Jean

Stallworth, Acquawon Jean is an individual health care provider with primary practice located at 1904 Jake Alexander Blvd W Ste 301 , Salisbury NC 28147-1177. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Stallworth, Acquawon Jean can be contacted via phone (704) 797-2442.

Contact Information

Primary practice address
1904 Jake Alexander Blvd W Ste 301 Salisbury NC 28147-1177
Phone: (704) 797-2442
Fax: (704) 797-2443
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2001-00610 North Carolina

Profile Details

NPI number 1336135623
LBN Legal business name Stallworth, Acquawon Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2005
Last updated Dec 19th, 2023 - about 2 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 1336135623 NPPES
North Carolina MEDICAID 89129PP

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