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Individual

DR. STEPHEN MINNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
751 FOREST AVE, SUITE 401, ZANESVILLE, OH 43701-2868
(740) 454-8502
(740) 454-8641
Mailing address
860 BETHESDA DR, ZANESVILLE, OH 43701-1800
(740) 454-4651
(740) 454-4653

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35054785M
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000019439
ANTHEM PIN
OH
01
000000177369
UNISON PIN
OH
05
0701244
OH
01
0989499
GROUP MEDICAID
OH
01
1204559
UHC PIN
OH
01
311413469027
CARESOURCE PIN
OH
Enumeration date
12/21/2005
Last updated
04/01/2008
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