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ANDREW CHRISTIAN STEVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
580 W COLLEGE AVENUE, MARQUETTE, MI 49855
(906) 225-7414
(906) 225-3031
Mailing address
4602 DEPT, CAROL STREAM, IL 60122-0021
(906) 225-4821
(906) 225-4537

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301084023
MI
208D00000X
General Practice Physician
Primary
4301084023
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5192136
MI
01
AS084023
BCBS OF MICHIGAN
MI
01
P00423091
RAILROAD MEDICARE
MI
Enumeration date
05/04/2007
Last updated
04/28/2009
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