Individual
DENNIS LEROY STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
4461 E VICTORY RD, MERIDIAN, ID 83642-7011
(208) 362-7144
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
M-5648
ID
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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