Individual
BRIAN S STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3600 KOLBE RD, SUITE 227, LORAIN, OH 44053-1654
(440) 960-3304
(440) 960-3482
Mailing address
PO BOX 636643, CINCINNATI, OH 45263-6643
(440) 989-3801
(440) 960-0264
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002340
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0236248
—
OH
05
—
2189859
—
OH
05
—
3025372
—
OH
Enumeration date
05/04/2006
Last updated
10/23/2014
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