Individual
TYLER K STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4095 MEADOWBROOK BLVD, UNIVERSITY HEIGHTS, OH 44118-3854
(216) 371-4171
Mailing address
9500 EUCLID AVE # A31, CLEVELAND, OH 44195-0001
(216) 445-1996
(216) 444-6284
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-081031
OH
207RG0100X
Gastroenterology Physician
Primary
81031
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000332717
ANTHEM
OH
05
—
2355768
—
OH
Enumeration date
12/23/2005
Last updated
06/13/2011
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