Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
NICHOLAS CARROLL DESTEFANO, MD
ActiveNICHOLAS CARROLL DESTEFANO, MD is a General Practice healthcare provider located in FORT GORDON, Georgia. NPI 1154776755 is currently active in the NPPES registry. Verify at CMS.
General Practice · FORT GORDON, GA
Registration Details
- NPI Number
- 1154776755
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 2, 2016 (10.285778501996 yrs)
- Last Updated
- Dec 10, 2025
- Licenses
-
30177 (NE)C1-0028577 (DE)
Practice Information
- Address
-
300 E HOSPITAL RDFORT GORDON, GA, 30905Browse GA providers · Browse ZIP 30905
- Phone
- 7063835299
- Primary Specialty
-
General Practice
208D00000X
- Additional Specialty
- Family Medicine
Other General Practice Providers in FORT GORDON, GA
| Name | Credential | NPI |
|---|---|---|
| CONSTANCE LARSON | MD | 1568951622 |
| GREGORY STEVEN HILL | MD | 1689209611 |
| REBECCA PHILPOTT | MD | 1689312886 |
| ANDREW JOSEPH SPRADER | DO | 1124767736 |
| DR. TRISTAN ALEXANDER RUIZ | MD | 1548957277 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.