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Individual
STEPHANIE C MAVIS
Active
Individual
STEPHANIE C MAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
59487
MN
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
59487
MN
Other
Enumeration date
07/29/2014
Last updated
09/30/2025
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