Individual
STEPHEN C MEDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8081 INNOVATION PARK DR FL 4, FAIRFAX, VA 22031-4867
(571) 472-1390
(571) 472-1391
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
0102207694
VA
207RH0000X
Hematology (Internal Medicine) Physician
34.010546
OH
207RH0000X
Hematology (Internal Medicine) Physician
44942
WI
207RH0000X
Hematology (Internal Medicine) Physician
6042
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047908000
—
MN
01
—
1134195159
ARAZ/ AMERICA'S PPO
SD
05
—
1134195159
—
IA
01
—
214D7ME
CC SYSTEMS/ BLUE PLUS
MN
01
—
253094
MIDLANDS CHOICE
SD
01
—
3600766
MEDICA
SD
01
—
370624200
DEPT OF LABOR
SD
05
—
46022474342
—
NE
01
—
4993050
BLUE CROSS
SD
01
—
57105AH10
WPS TRICARE
SD
01
—
6042
DAKOTACARE
SD
05
—
6631870
—
SD
01
—
678061051266
PREFERRED ONE
SD
01
—
92411422911
PRIMEWEST
MN
01
—
HP79180
HEALTHPARTNERS
SD
Enumeration date
02/28/2006
Last updated
06/29/2023
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