Individual
ROBERT RANDALL STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
116 NORTH ST, 2324 FAIRFIELD AVE, BLUEFIELD, WV 24701-4034
(304) 325-7186
(304) 325-7186
Mailing address
116 NORTH ST, 2324FAIRFIELD AVE., BLUEFIELD, WV 24701-4034
(304) 325-7186
(304) 325-7186
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2244
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133265000
—
WV
Enumeration date
01/29/2007
Last updated
07/08/2007
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