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Individual
MR. C DAVID STEPHENSON
Active
Individual
MR. C DAVID STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-070392
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036070392
—
IL
01
—
30664100
WISCONSIN MEDICAID
WI
Enumeration date
07/11/2005
Last updated
07/01/2015
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