Provider Demographics
NPI:1871580399
Name:VACALIS, STEVE ELEFTHERIS (DO)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:ELEFTHERIS
Last Name:VACALIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2711 X RAY DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-7491
Mailing Address - Country:US
Mailing Address - Phone:704-834-2420
Mailing Address - Fax:704-834-2426
Practice Address - Street 1:2711 X RAY DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7491
Practice Address - Country:US
Practice Address - Phone:704-834-2420
Practice Address - Fax:704-834-2426
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9901066207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891220GMedicaid
SCN01067Medicaid
NC891220GMedicaid
NC2400970Medicare PIN