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Individual

MR. CHRISTOPHER C STEPHENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(260) 969-1950
Mailing address
5633 RELIABLE PKWY, CHICAGO, IL 60686-0056
(260) 969-1950
(260) 918-2137

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000433A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000340097
BLUE CROSS/BLUE SHIELD
IN
01
P00180423
RAILROAD MEDICARE
IN
Enumeration date
07/20/2005
Last updated
02/17/2010
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