Individual
STEPHEN A COLVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1125 E SOUTHERN AVE, STE 300, MESA, AZ 85204-5045
(480) 545-8119
(480) 926-8332
Mailing address
1125 E SOUTHERN AVE, STE 300, MESA, AZ 85204-5045
(480) 545-8119
(480) 926-8332
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036.176148
IL
2085R0202X
Diagnostic Radiology Physician
Primary
27762
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215926274
BCBSAZ
AZ
01
—
1Z7135
HEALTH NET
AZ
05
—
574857
—
AZ
01
—
82680
JRL
AZ
01
—
Z142685
MEDICCARE PTAN - ARL
—
01
—
Z142686
MEDICARE PTAN - EVDI
AZ
Enumeration date
10/20/2005
Last updated
07/23/2025
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