Individual
STEVEN L CLEMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
37325
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203554085
FEDERAL TAX ID
—
05
—
3732052
—
TN
05
—
3882671
—
TN
01
—
4114638
BLUE CROSS BLUE SHIELD
TN
Enumeration date
07/10/2006
Last updated
10/12/2015
Update your record
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