| Doctor Name: | STEPHEN UTENICK |
| NPI Number: | 1093960957 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | SA-C |
| License Number: | 95-108 |
| Business Practice Address: | 105 Beason Farm Ln Simpsonville, SC - 296816509 |
| Business Phone Number: | 8644141164 |
| Business Fax Number: | |
| Mailing Address: | 105 Beason Farm Ln, SIMPSONVILLE |
| State: | SC |
| Postal Code: | 296816509 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/19/2008 |
| NPI Last Update Date: | 11/19/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 95-108 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |