Individual
STEPHEN JAMES MITTELSTAEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
103 OMNI DR STE B, SENECA, SC 29672-9448
(864) 886-9250
(864) 886-9251
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6303
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33135
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331359
—
SC
Enumeration date
07/18/2006
Last updated
02/15/2018
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