Individual
STEPHEN B. CHANNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4105 PEMBROKE RD, HOLLYWOOD, FL 33021-8103
(954) 985-3441
Mailing address
PO BOX 452376, SUNRISE, FL 33345-2376
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME61226
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254847000
—
FL
01
—
58601
BCBS OF FL
FL
Enumeration date
01/19/2006
Last updated
10/15/2007
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