Individual
JAMES C STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7956 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 436-2416
(260) 436-9662
Mailing address
7956 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 436-2416
(260) 436-9662
Taxonomy
Speciality
Code
Description
License number
State
2080S0012X
Pediatric Sleep Medicine Physician
01033527A
IN
2084N0400X
Neurology Physician
Primary
01033527A
IN
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
01033527A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020007659
RR MEDICARE
IN
05
—
0667603
—
OH
05
—
100096030
—
IN
05
—
2717865
—
MI
Enumeration date
07/07/2005
Last updated
07/27/2023
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