Individual
DR. ANTONIA ELIZABETH STEPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, SURGICAL ONCOLOGY ASSOCIATES YAW 7B, BOSTON, MA 02114-2621
(617) 726-0531
(617) 724-3895
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-0531
(617) 724-3895
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
160829
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041031
—
MA
01
—
760800
TUFTS HEALTH PLAN
MA
01
—
J27326
BCBS MA
MA
Enumeration date
11/14/2005
Last updated
07/30/2012
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