Individual
EDWARD R STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 233-4082
Mailing address
PO BOX 854, MC A410, HERSHEY, PA 17033-0854
(800) 233-4082
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD057084L
PA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD057084L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018979650001
—
PA
Enumeration date
04/26/2006
Last updated
07/21/2022
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