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Individual
DR. STEPHEN NYSTROM
Active
Individual
DR. STEPHEN NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
5101017624
MI
207X00000X
Orthopaedic Surgery Physician
Primary
68888-21
WI
207X00000X
Orthopaedic Surgery Physician
OS12697
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013076600
—
FL
05
—
100075914
—
WI
01
—
14V7E
BCBS FL
FL
01
—
P01408649
RAILROAD MEDICARE
FL
Enumeration date
06/11/2008
Last updated
03/27/2024
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